| NPI | 1174135347 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 12872784-3501) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: UT 12872784-3501) |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2020-08-19 |
| Last Update Date | 2024-10-21 |