NPI | 1316527112 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 10176-125) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AZ LPC-19799) |
101YP2500X Counselor, Professional (Licence: MN 2764) | |
Enumeration Date | 2021-04-14 |
Last Update Date | 2022-12-23 |