| NPI | 1760993984 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA LPC005580) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: GA LPC005580) |
| 101YP2500X Counselor, Professional (Licence: GA LPC005580) | |
| 101YS0200X Counselor, School (Licence: GA 867988) | |
| Enumeration Date | 2017-10-15 |
| Last Update Date | 2019-09-13 |