| NPI | 1659663086 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: GA LPC003014) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: GA LPC003014) |
| 101Y00000X Counselor (Licence: GA LPC003014) | |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: GA LPC003014) | |
| Enumeration Date | 2011-05-03 |
| Last Update Date | 2012-03-07 |