NPI | 1164150074 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701011597) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 91438) |
103TC1900X Psychologist, Counseling (Licence: VA 0701011597) | |
Enumeration Date | 2022-08-09 |
Last Update Date | 2023-08-22 |