NPI | 1235551847 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SD LPC-MH 2183) |
Additional Taxonomies | 103TS0200X Psychologist, School (Licence: SD LAC 08051363) |
Enumeration Date | 2014-01-16 |
Last Update Date | 2014-01-16 |