NPI | 1487900619 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH17037) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MO 2011021465) |
101YM0800X Counselor, Mental Health (Licence: KS 2100) | |
Enumeration Date | 2012-07-25 |
Last Update Date | 2019-06-14 |