NPI | 1295090249 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: 5945) |
Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: CO 5945) |
Enumeration Date | 2012-07-05 |
Last Update Date | 2023-11-09 |