NPI | 1821365404 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC011231) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO LPC-5984) |
Enumeration Date | 2011-11-25 |
Last Update Date | 2024-02-13 |