NPI | 1053700831 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH16550) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: FL MT3595) |
101Y00000X Counselor | |
Enumeration Date | 2015-01-15 |
Last Update Date | 2024-05-06 |