NPI | 1730555095 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VT 068.0117129) |
Additional Taxonomies | 101Y00000X Counselor (Licence: VT 0970081292) |
101YM0800X Counselor, Mental Health (Licence: MA 8954) | |
Enumeration Date | 2015-08-20 |
Last Update Date | 2019-04-24 |