NPI | 1467017657 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL 17496) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MT bbh-lcpc-lic-38063) |
Enumeration Date | 2019-05-03 |
Last Update Date | 2021-04-13 |