| NPI | 1659532422 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH6386) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL 1-02-0809) |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2008-06-24 |