NPI | 1518104090 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor (Licence: CO LPC005603) |
Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CO LPC5603) |
101YM0800X Counselor Mental Health (Licence: UT 7115918-6009) | |
Enumeration Date | 2009-01-20 |
Last Update Date | 2022-07-21 |