| NPI | 1245870070 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH20571) |
| Enumeration Date | 2020-01-09 |
| Last Update Date | 2023-02-23 |