| NPI | 1760417539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC004421) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: LA 2995) |
| 106H00000X Marriage & Family Therapist (Licence: LA 989) | |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2019-06-24 |