NPI | 1821396219 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: ID 6662) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MT BBH-LCPC-LIC-23179) |
Enumeration Date | 2011-03-09 |
Last Update Date | 2018-03-30 |