NPI | 1659764835 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD 17703) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VA 0904011683) |
Enumeration Date | 2015-03-11 |
Last Update Date | 2024-09-17 |