| NPI | 1336806389 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 178.017485) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: IL 178.017485) |
| Enumeration Date | 2021-11-24 |
| Last Update Date | 2023-11-17 |