NPI | 1699035857 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701005868) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR C2679) |
Enumeration Date | 2012-05-22 |
Last Update Date | 2015-06-29 |