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 |