NPI | 1629646609 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC0017108) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 82375) |
Enumeration Date | 2021-06-15 |
Last Update Date | 2021-06-15 |