| NPI | 1750238143 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 178022880) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IL 208011653) |
| Enumeration Date | 2026-03-13 |
| Last Update Date | 2026-03-25 |