NPI | 1306229737 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 072148) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VT 068.0135436TELE) |
101YP2500X Counselor, Professional (Licence: WI 10444-125) | |
Enumeration Date | 2015-07-02 |
Last Update Date | 2023-10-10 |