NPI | 1407128499 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: LA 3824) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: LA 3824) |
Enumeration Date | 2012-02-06 |
Last Update Date | 2023-07-19 |