NPI | 1194964346 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MT LCPC-1283) |
Additional Taxonomies | 174400000X Specialist (Licence: MT 1283-LCPC) |
Enumeration Date | 2009-02-11 |
Last Update Date | 2024-03-30 |