NPI | 1780836510 |
---|---|
Former Name | BIRD VITKO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0701005638) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC 7167) |
Enumeration Date | 2008-10-10 |
Last Update Date | 2022-05-03 |