| NPI | 1023853009 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: PA APC000726) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| 225A00000X Music Therapist | |
| Enumeration Date | 2024-07-01 |
| Last Update Date | 2025-06-26 |