| NPI | 1356631865 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CT 002030) |
| Additional Taxonomies | 101YS0200X Counselor, School (Licence: CT 002030) |
| Enumeration Date | 2011-04-18 |
| Last Update Date | 2022-12-21 |