| NPI | 1912631615 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC013772) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: SC 11447) |
| Enumeration Date | 2022-07-11 |
| Last Update Date | 2025-11-03 |