| NPI | 1790213940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: GA LPC014844) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: TX 96434) |
| Enumeration Date | 2017-06-01 |
| Last Update Date | 2025-01-07 |