| NPI | 1629103940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA LPC1833) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: GA LMFT866) |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2007-07-08 |