NPI | 1871036046 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor (Licence: MT BBH-LCPC-LIC-23182) |
Additional Taxonomies | 101Y00000X Counselor (Licence: MT 23182) |
Enumeration Date | 2016-11-21 |
Last Update Date | 2024-03-29 |