| NPI | 1770880692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA LPC007468) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH10344) |
| Enumeration Date | 2011-02-14 |
| Last Update Date | 2014-08-08 |