NPI | 1972042091 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA LPCPC009408) |
Additional Taxonomies | 101Y00000X Counselor (Licence: GA LPCPC009408) |
101YM0800X Counselor, Mental Health (Licence: GA LPC009408) | |
Enumeration Date | 2017-02-22 |
Last Update Date | 2020-09-18 |