NPI | 1720487275 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA LPC010376) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
101YM0800X Counselor, Mental Health (Licence: FL MH12991) | |
Enumeration Date | 2014-08-21 |
Last Update Date | 2019-07-21 |