| NPI | 1720472111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: GA LPC011104) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NC A11532) |
| 101YM0800X Counselor Mental Health (Licence: NC 11532) | |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2019-10-17 |