NPI | 1619120011 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC 0011124) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2008-10-29 |
Last Update Date | 2013-05-14 |