| NPI | 1639989890 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA LMHC10003437) |
| Additional Taxonomies | 221700000X Art Therapist |
| Enumeration Date | 2025-01-09 |
| Last Update Date | 2025-01-09 |