NPI | 1326783903 |
---|---|
Entity Type | Individual |
Gender | N/A |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.0021178) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO LPCC.0018828) |
Enumeration Date | 2022-04-28 |
Last Update Date | 2024-10-14 |