| NPI | 1932718285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701009610) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA LPC013085) |
| 251S00000X Community/Behavioral Health | |
| Enumeration Date | 2020-07-23 |
| Last Update Date | 2022-09-21 |