| NPI | 1700611803 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NV CI5438) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2024-09-06 |
| Last Update Date | 2024-10-14 |