NPI | 1164287553 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC LCMHCAA19478) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC A19478) |
Enumeration Date | 2024-02-15 |
Last Update Date | 2024-02-15 |