NPI | 1053761783 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180.010309) |
Additional Taxonomies | 101Y00000X Counselor (Licence: IL 180.010309) |
101YP2500X Counselor, Professional (Licence: IL 180.010309) | |
Enumeration Date | 2016-06-14 |
Last Update Date | 2023-11-13 |