| NPI | 1518732163 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YP1600X Counselor, Pastoral | |
| Enumeration Date | 2023-11-22 |
| Last Update Date | 2024-03-10 |