| NPI | 1780112268 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MS 1876) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI 10750-125) |
| 101YM0800X Counselor, Mental Health (Licence: AZ 22744) | |
| 101YM0800X Counselor, Mental Health (Licence: PA PC017516) | |
| 101YP2500X Counselor, Professional (Licence: MS 1876) | |
| 101YP2500X Counselor, Professional (Licence: PA PC017516) | |
| Enumeration Date | 2017-05-30 |
| Last Update Date | 2024-10-18 |