| NPI | 1710869003 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: LA PLC10783) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: LA plc10783) |
| Enumeration Date | 2025-07-25 |
| Last Update Date | 2025-07-25 |