NPI | 1467704569 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NM CMH0207121) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NM T0152441) |
Enumeration Date | 2012-10-12 |
Last Update Date | 2019-12-18 |