| NPI | 1245810167 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 7682) |
| Additional Taxonomies | 221700000X Art Therapist (Licence: 08-056) |
| Enumeration Date | 2021-04-13 |
| Last Update Date | 2021-04-13 |