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 |