NPI | 1205335130 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VT 068.0102645) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 1997) |
Enumeration Date | 2018-02-06 |
Last Update Date | 2018-03-16 |