NPI | 1083959332 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ID LCPC-5876) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ID LPC-5912) |
101YP2500X Counselor, Professional (Licence: MT 2407) | |
Enumeration Date | 2012-11-27 |
Last Update Date | 2021-03-17 |