NPI | 1154684603 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OK 5276) |
Additional Taxonomies | 101Y00000X Counselor (Licence: OK 5276) |
101YP2500X Counselor, Professional (Licence: OK 5276) | |
Enumeration Date | 2012-06-20 |
Last Update Date | 2014-10-22 |