| NPI | 1689973984 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: GA LPC 007612) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: GA MFT 001281) |
| Enumeration Date | 2011-03-25 |
| Last Update Date | 2016-03-30 |