| NPI | 1902220825 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: GA LPC007481) |
| Additional Taxonomies | 101YS0200X Counselor School (Licence: GA 462269) |
| Enumeration Date | 2014-02-12 |
| Last Update Date | 2021-04-01 |