| NPI | 1508150079 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101Y00000X Counselor (Licence: GA LPC007610) | 
| Additional Taxonomies | 101Y00000X Counselor (Licence: GA APC002762) | 
| Enumeration Date | 2011-06-02 | 
| Last Update Date | 2019-02-04 |