NPI | 1780747246 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC005522) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: GA LPC005522) |
106H00000X Marriage & Family Therapist (Licence: GA LPC005522) | |
Enumeration Date | 2006-12-18 |
Last Update Date | 2009-06-09 |