| NPI | 1790544054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC014211) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH4161) |
| Enumeration Date | 2024-03-18 |
| Last Update Date | 2026-01-06 |