| NPI | 1619460425 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YP2500X Counselor, Professional | 
| Additional Taxonomies | 101Y00000X Counselor (Licence: GA LPC010221) | 
| 101YM0800X Counselor, Mental Health (Licence: GA LPC010221) | |
| Enumeration Date | 2018-06-07 | 
| Last Update Date | 2022-10-24 |