NPI | 1700152097 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: GA MFT001224) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA LPC006659) |
Enumeration Date | 2012-03-30 |
Last Update Date | 2022-11-14 |