NPI | 1144068149 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701013404) |
Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
Enumeration Date | 2024-07-16 |
Last Update Date | 2024-07-16 |