| NPI | 1003646415 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPCC.0021394) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO LPCC.0021394) |
| 225600000X Dance Therapist (Licence: CO LPCC.0021394) | |
| Enumeration Date | 2024-08-02 |
| Last Update Date | 2024-08-02 |