| NPI | 1942713664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC010923) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: SC LPC10860) |
| 101YM0800X Counselor, Mental Health (Licence: GA LPC010923) | |
| 101YP2500X Counselor, Professional (Licence: SC LPC10860) | |
| 251S00000X Community/Behavioral Health (Licence: GA 005087) | |
| Enumeration Date | 2017-11-16 |
| Last Update Date | 2025-08-15 |