| NPI | 1316763030 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2020032634) |
| Additional Taxonomies | 221700000X Art Therapist (Licence: 22-215) |
| Enumeration Date | 2024-11-26 |
| Last Update Date | 2024-11-26 |