| NPI | 1316561053 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ME CC7060) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: ME XL5268) |
| Enumeration Date | 2020-05-28 |
| Last Update Date | 2023-03-24 |