NPI | 1255784534 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO LPC.0015419) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO LPCC.0014752) |
Enumeration Date | 2016-07-21 |
Last Update Date | 2019-07-18 |