| NPI | 1750773487 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: GA LPC002892) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: GA 1502-R) |
| 101YP2500X Counselor Professional (Licence: VA 0701002691) | |
| Enumeration Date | 2015-03-04 |
| Last Update Date | 2015-03-04 |