NPI | 1396972022 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MT 967 LCPC) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OR CO 555) |
Enumeration Date | 2009-06-21 |
Last Update Date | 2009-06-21 |