| NPI | 1700174653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC008937) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AL 2931) |
| Enumeration Date | 2011-07-13 |
| Last Update Date | 2017-03-23 |