| NPI | 1457010225 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: PA PC013923) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: PA PC013923) |
| 101YP2500X Counselor, Professional (Licence: PA PC013923) | |
| Enumeration Date | 2021-12-09 |
| Last Update Date | 2021-12-09 |