NPI | 1124590278 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC13255) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
101YP2500X Counselor, Professional (Licence: MD LC13255) | |
101YP2500X Counselor, Professional (Licence: MD LGP8992) | |
Enumeration Date | 2018-12-28 |
Last Update Date | 2023-03-09 |