NPI | 1417274101 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AK PCOP797) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: ID LCPC-8101) |
Enumeration Date | 2010-04-21 |
Last Update Date | 2021-04-13 |