| NPI | 1912223124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701005533) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA LPC005123) |
| Enumeration Date | 2010-04-13 |
| Last Update Date | 2019-11-19 |