NPI | 1740636158 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH16993) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VA 0701006635) |
174400000X Specialist (Licence: CA LPCC2781) | |
Enumeration Date | 2016-05-05 |
Last Update Date | 2020-04-02 |