| NPI | 1679469910 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 14439) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NE 8211) |
| Enumeration Date | 2025-06-13 |
| Last Update Date | 2025-07-16 |