NPI | 1679809487 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH11790) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NM CCMH0203951) |
101YM0800X Counselor, Mental Health (Licence: CO LPC.0014703) | |
101YM0800X Counselor, Mental Health (Licence: VI 2-28262-2B) | |
Enumeration Date | 2009-10-29 |
Last Update Date | 2021-10-27 |