| NPI | 1518322395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA lpc010510) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: GA mft001529) |
| Enumeration Date | 2015-12-22 |
| Last Update Date | 2020-11-08 |