| NPI | 1639526296 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 11447) |
| Additional Taxonomies | 221700000X Art Therapist (Licence: NH 21-110) |
| Enumeration Date | 2016-05-24 |
| Last Update Date | 2021-06-08 |