| NPI | 1881112217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: GA LPC012859) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: GA APC006917) |
| 171W00000X Contractor | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-09-06 |
| Last Update Date | 2022-08-24 |