| NPI | 1750803706 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401224336) |
| Additional Taxonomies | 221700000X Art Therapist (Licence: 22-348) |
| Enumeration Date | 2017-07-12 |
| Last Update Date | 2024-10-10 |