| NPI | 1508532466 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: CA APCC11952) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA APCC11952) |
| 101YP2500X Counselor, Professional (Licence: CA APCC11952) | |
| Enumeration Date | 2021-08-20 |
| Last Update Date | 2025-07-09 |