NPI | 1194118166 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH12608) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA LPC011752) |
Enumeration Date | 2015-03-13 |
Last Update Date | 2024-05-01 |