NPI | 1740684802 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC006625) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO LPC.0013754) |
Enumeration Date | 2014-10-18 |
Last Update Date | 2024-01-16 |