| NPI | 1992073464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC006615) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: GA MFT001251) |
| Enumeration Date | 2011-12-12 |
| Last Update Date | 2013-01-07 |