NPI | 1912143447 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor (Licence: MA #83LMHC) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 83-CC) |
101YM0800X Counselor, Mental Health (Licence: MA #83#32529) | |
Enumeration Date | 2009-01-06 |
Last Update Date | 2012-05-25 |