| NPI | 1740599273 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AL L578) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AL 578) |
| 101YM0800X Counselor, Mental Health (Licence: AL L578) | |
| Enumeration Date | 2010-10-01 |
| Last Update Date | 2025-02-02 |