| NPI | 1497271746 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA MFT001555) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: GA LPC009629) |
| Enumeration Date | 2017-08-18 |
| Last Update Date | 2017-08-18 |