NPI | 1124551254 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA LPC011920) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 76004) |
Enumeration Date | 2017-04-05 |
Last Update Date | 2024-09-18 |