NPI | 1831920891 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: CA 123346) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 123346) |
Enumeration Date | 2024-08-12 |
Last Update Date | 2024-08-12 |