| NPI | 1861007916 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WA 61320033) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: ID 7756) |
| Enumeration Date | 2020-09-14 |
| Last Update Date | 2024-07-17 |