NPI | 1497395255 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA LPCC10515) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MT BBH-LCPC-LIC-38202) |
Enumeration Date | 2020-01-09 |
Last Update Date | 2021-10-27 |