NPI | 1407376536 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH25502) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6401017288) |
101YM0800X Counselor, Mental Health (Licence: NM CMH0211101) | |
101YS0200X Counselor, School (Licence: MI PV0000000820594) | |
Enumeration Date | 2017-06-20 |
Last Update Date | 2025-07-13 |