NPI | 1821622515 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 11630) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VT 068.0134961TELE) |
Enumeration Date | 2020-03-03 |
Last Update Date | 2023-11-10 |