NPI | 1992923395 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: GA LPC875) |
Additional Taxonomies | 103T00000X Psychologist (Licence: GA 2248) |
106H00000X Marriage & Family Therapist (Licence: GA MFT502) | |
Enumeration Date | 2007-04-23 |
Last Update Date | 2007-07-08 |