NPI | 1134663313 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH E.1800520-SUPV) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: OH F.1800035-SUPV) |
Enumeration Date | 2016-12-07 |
Last Update Date | 2020-01-23 |