| NPI | 1609338342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: GA LPC011938) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: GA 006091) |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2022-12-29 |