NPI | 1528306990 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC010782) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NJ 37PC00465000) |
101YM0800X Counselor, Mental Health (Licence: NC 12953) | |
Enumeration Date | 2013-01-19 |
Last Update Date | 2024-02-12 |