| NPI | 1639422520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: GA LPC00431) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling (Licence: GA PSY003371) |
| Enumeration Date | 2012-10-17 |
| Last Update Date | 2012-10-17 |