| NPI | 1982148680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC011100) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: GA LPC011100) |
| 101YM0800X Counselor, Mental Health (Licence: TX 73342) | |
| 101YP2500X Counselor, Professional (Licence: TX 73342) | |
| Enumeration Date | 2016-12-14 |
| Last Update Date | 2024-09-26 |