NPI | 1720658636 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2004015206) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MO 2514) |
101YM0800X Counselor, Mental Health (Licence: MO 2004015206) | |
Enumeration Date | 2021-07-01 |
Last Update Date | 2021-07-01 |