| NPI | 1942458633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC004097) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VT 068.0134132) |
| Enumeration Date | 2008-09-05 |
| Last Update Date | 2024-01-23 |