| NPI | 1497303218 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 2829) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NE 11931) |
| Enumeration Date | 2019-08-27 |
| Last Update Date | 2024-02-14 |