| NPI | 1790972412 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MO 2015032865) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA LPC004750) |
| Enumeration Date | 2007-09-26 |
| Last Update Date | 2024-09-11 |