| NPI | 1144681750 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AK 137962) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH61576673) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2016-03-09 |
| Last Update Date | 2025-01-09 |