NPI | 1710284013 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC1907) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: DC PRC14080) |
101YM0800X Counselor, Mental Health (Licence: VA 0701004771) | |
Enumeration Date | 2011-02-22 |
Last Update Date | 2011-02-22 |