NPI | 1124862602 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AL LPC04856) |
Additional Taxonomies | 101YS0200X Counselor, School (Licence: AL BLH-0115-4975) |
Enumeration Date | 2024-06-20 |
Last Update Date | 2024-06-20 |