| NPI | 1962866814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: GA LPC009009) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 101YM0800X Counselor Mental Health | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| Enumeration Date | 2016-04-07 |
| Last Update Date | 2017-11-21 |