| NPI | 1518277482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC010497) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY 1104) |
| Enumeration Date | 2010-10-13 |
| Last Update Date | 2023-05-22 |