| NPI | 1619368255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA LPC008872) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: GA APC004715) |
| Enumeration Date | 2015-02-17 |
| Last Update Date | 2018-07-26 |