| NPI | 1609268853 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: GA LPC005911) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: GA LPC005911) |
| Enumeration Date | 2015-02-25 |
| Last Update Date | 2015-02-25 |