NPI | 1053781146 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NM CCMH0206261) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 2316-226) |
Enumeration Date | 2015-10-01 |
Last Update Date | 2019-09-27 |