NPI | 1154776524 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: DC PRC15066) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LC7873) |
164W00000X Licensed Practical Nurse (Licence: DC LPN1006945) | |
Enumeration Date | 2016-05-04 |
Last Update Date | 2023-09-01 |