| NPI | 1306191390 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 8717) |
| Additional Taxonomies | 221700000X Art Therapist (Licence: 06-020) |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2025-01-09 |