| NPI | 1962880476 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: VA 0701006122) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: GA LPC006866) |
| Enumeration Date | 2015-05-16 |
| Last Update Date | 2017-01-24 |