NPI | 1386029460 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: SD LPC-MH30739) |
Additional Taxonomies | 101Y00000X Counselor (Licence: SD LPC7118) |
Enumeration Date | 2015-07-30 |
Last Update Date | 2022-10-03 |