NPI | 1285088260 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 16243) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC 16243) |
261QM0850X Clinic/Center, Adult Mental Health (Licence: NC 16243) | |
Enumeration Date | 2016-04-16 |
Last Update Date | 2024-10-28 |