| NPI | 1740538511 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH11927) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH 11927) |
| Enumeration Date | 2012-08-27 |
| Last Update Date | 2022-08-12 |