| NPI | 1760859979 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: GA LPC010866) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: GA LPC010866) |
| 101YM0800X Counselor Mental Health (Licence: GA 209382) | |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2025-07-21 |