| NPI | 1962795625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA LPC011133) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL IMH8543) |
| 101YM0800X Counselor, Mental Health (Licence: FL MH12484) | |
| Enumeration Date | 2011-05-27 |
| Last Update Date | 2024-04-12 |