| NPI | 1376351510 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA MC61633726) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: PA APC000678) |
| Enumeration Date | 2024-12-19 |
| Last Update Date | 2025-01-24 |