NPI | 1275090789 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VT 097.0132079) |
Additional Taxonomies | 101Y00000X Counselor (Licence: VT 151.0132738) |
Enumeration Date | 2019-02-21 |
Last Update Date | 2020-10-26 |