| NPI | 1508355934 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA LPC012554)  | 
| Additional Taxonomies | 101Y00000X Counselor (Licence: GA APC006350)  | 
| Enumeration Date | 2018-05-01 | 
| Last Update Date | 2022-08-22 |