NPI | 1174869218 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH60776880) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MD LC5763) |
101YP2500X Counselor, Professional (Licence: GA LPC011670) | |
Enumeration Date | 2012-12-18 |
Last Update Date | 2022-05-06 |