| NPI | 1568359495 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 8364-226) |
| Additional Taxonomies | 221700000X Art Therapist (Licence: WI 24-881) |
| Enumeration Date | 2025-06-23 |
| Last Update Date | 2025-06-23 |