| NPI | 1740373711 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: GA LPC004368) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: NC 4971) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2017-04-18 |