NPI | 1053809749 |
---|---|
Former Name | VICTORIA MARIE BONI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH E.2102087) |
Additional Taxonomies | 101Y00000X Counselor (Licence: OH C.1700625-TRNE) |
101YP2500X Counselor, Professional (Licence: OH E.2102087) | |
Enumeration Date | 2018-04-27 |
Last Update Date | 2024-12-26 |