NPI | 1164026167 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH19803) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: FL IMT2609) |
Enumeration Date | 2020-11-30 |
Last Update Date | 2021-11-02 |