| NPI | 1336652460 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180.014784) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 178.013451) |
| Enumeration Date | 2017-11-11 |
| Last Update Date | 2024-04-28 |