NPI | 1710242532 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ LAC-20665) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 178.006898) |
Enumeration Date | 2012-07-09 |
Last Update Date | 2024-08-20 |