NPI | 1245975895 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MT BBH-LCPC-LIC-70116) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MT BBH-MFLC-LIC-55294) |
Enumeration Date | 2022-04-28 |
Last Update Date | 2024-02-05 |