NPI | 1346601499 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA LPC011097) |
Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6401014552) |
Enumeration Date | 2016-03-17 |
Last Update Date | 2021-02-16 |