| NPI | 1518849884 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: DC PRC200001823) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VA 0701012734) |
| Enumeration Date | 2025-07-25 |
| Last Update Date | 2025-07-25 |