NPI | 1154988780 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MO 2024014472) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS 859) |
101YM0800X Counselor, Mental Health (Licence: KS LCPC03713) | |
Enumeration Date | 2019-05-20 |
Last Update Date | 2024-06-27 |