NPI | 1023772266 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO LPC.0019769) |
Additional Taxonomies | 101Y00000X Counselor (Licence: TX 95240) |
Enumeration Date | 2021-10-25 |
Last Update Date | 2024-09-03 |