NPI | 1073068797 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL PMH1569) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LCPC8484) |
Enumeration Date | 2016-08-23 |
Last Update Date | 2018-11-09 |