NPI | 1174285969 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA LMHC10002937) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LC14465) |
Enumeration Date | 2021-10-08 |
Last Update Date | 2024-11-09 |