| NPI | 1558630525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC5482) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional (Licence: GA LPC011048) | |
| Enumeration Date | 2011-12-21 |
| Last Update Date | 2019-11-26 |