| NPI | 1912074733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA 012805) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: SC 5486) |
| 101YP2500X Counselor, Professional (Licence: GA LPC012805) | |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2022-09-14 |