| NPI | 1427887355 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MA 10002784) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 221700000X Art Therapist | |
| Enumeration Date | 2024-07-30 |
| Last Update Date | 2024-09-19 |