NPI | 1730507385 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC00984) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: GA MFT001617) |
Enumeration Date | 2014-04-01 |
Last Update Date | 2018-07-20 |