NPI | 1215067095 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA LPC22) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA LPC22) |
Enumeration Date | 2007-03-07 |
Last Update Date | 2012-06-07 |