| NPI | 1639613243 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701008462) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA LPC010706) |
| Enumeration Date | 2016-12-16 |
| Last Update Date | 2022-12-05 |