NPI | 1124307095 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.0013739) |
Additional Taxonomies | 101Y00000X Counselor |
101YM0800X Counselor, Mental Health (Licence: CO LPC.0013739) | |
Enumeration Date | 2011-08-10 |
Last Update Date | 2018-08-21 |