NPI | 1568872406 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 10584) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
106H00000X Marriage & Family Therapist (Licence: NC 9079A) | |
252Y00000X Early Intervention Provider Agency | |
Enumeration Date | 2014-04-30 |
Last Update Date | 2024-01-29 |