| NPI | 1790060176 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC011582) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health (Licence: GA LPC011582) | |
| Enumeration Date | 2011-10-17 |
| Last Update Date | 2023-04-02 |