| NPI | 1629197116 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: GA LPC003510) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: GA LPC003510) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2007-07-08 |