| NPI | 1851262877 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NC A22030) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC A22030) |
| Enumeration Date | 2025-09-15 |
| Last Update Date | 2025-09-15 |