| NPI | 1366926263 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 14190) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 14190) |
| 101YP2500X Counselor, Professional (Licence: NC A14190) | |
| Enumeration Date | 2018-09-18 |
| Last Update Date | 2024-07-03 |