| NPI | 1518754878 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC A21152) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC 1736109) |
| 101YS0200X Counselor, School (Licence: NC 1212869) | |
| Enumeration Date | 2025-04-21 |
| Last Update Date | 2025-04-21 |