NPI | 1992092712 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC007904) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: GA MFT001334) |
Enumeration Date | 2011-06-30 |
Last Update Date | 2014-10-01 |