| 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 |