| NPI | 1619563202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC014479) |
| Additional Taxonomies | 106E00000X Assistant Behavior Analyst |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2020-12-17 |
| Last Update Date | 2024-04-04 |