| NPI | 1568767499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 004585) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: SC 5050) |
| 101YP2500X Counselor, Professional (Licence: GA LPC006302) | |
| 235Z00000X Speech-Language Pathologist, (Licence: GA SLP004913) | |
| 235Z00000X Speech-Language Pathologist, (Licence: SC SLP3263) | |
| Enumeration Date | 2011-01-25 |
| Last Update Date | 2017-01-04 |