| NPI | 1689040883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: GA LPC008197) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: CT 3167) |
| Enumeration Date | 2015-08-11 |
| Last Update Date | 2020-02-21 |