NPI | 1265975007 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MO 2011030266) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MO 2011030266) |
Enumeration Date | 2016-11-28 |
Last Update Date | 2016-11-28 |