NPI | 1235774696 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701010214) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0001152431) |
101YM0800X Counselor, Mental Health (Licence: VA 0701010214) | |
101YM0800X Counselor, Mental Health (Licence: MD LC13328) | |
Enumeration Date | 2019-11-08 |
Last Update Date | 2024-11-04 |