NPI | 1104567197 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC15161) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: SC 9595) |
101YM0800X Counselor, Mental Health (Licence: NC 20444) | |
Enumeration Date | 2022-04-05 |
Last Update Date | 2025-09-24 |