| NPI | 1023594363 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KS 03105) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KS 03105) |
| 101YM0800X Counselor, Mental Health (Licence: KS 3279) | |
| Enumeration Date | 2018-07-18 |
| Last Update Date | 2024-10-29 |