| NPI | 1902332562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA LPC009456) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: GA LPC009456) |
| 101YP2500X Counselor, Professional (Licence: GA LPC009456) | |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2017-05-02 |