NPI | 1861081200 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MT 65953) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MT BBH-PCLC-LIC-45189) |
101YM0800X Counselor, Mental Health (Licence: MT BBH-LCPC-LIC-65953) | |
Enumeration Date | 2021-01-11 |
Last Update Date | 2024-01-18 |