| NPI | 1760414387 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: GA LPC004290) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NY 005172) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2013-03-22 |