NPI | 1639155781 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL 19009) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NY 011694-01) |
101YP2500X Counselor, Professional (Licence: IL 180-004968) | |
Enumeration Date | 2005-12-21 |
Last Update Date | 2024-06-20 |