NPI | 1265702161 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC12690) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: PA PC006181) |
Enumeration Date | 2012-01-09 |
Last Update Date | 2024-11-04 |