NPI | 1174096648 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: DC LGPC00394) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LGP8846) |
Enumeration Date | 2019-01-08 |
Last Update Date | 2019-01-08 |