| NPI | 1609223965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC002978) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: VA 0701004444) |
| Enumeration Date | 2016-05-17 |
| Last Update Date | 2021-08-26 |