| NPI | 1477708287 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: GA CSW008077) |
| Enumeration Date | 2008-11-20 |
| Last Update Date | 2023-06-12 |