NPI | 1053015537 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MT BBH-LCPC-LIC-55796) |
Additional Taxonomies | 101YP2500X Counselor Professional (Licence: MT BBH-LCPC-LIC-55796) |
Enumeration Date | 2023-03-28 |
Last Update Date | 2024-02-12 |