| NPI | 1326759283 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CO LPC.0020900) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CO LPC.0020900) |
| 101YP2500X Counselor Professional | |
| Enumeration Date | 2022-12-12 |
| Last Update Date | 2024-06-27 |