NPI | 1912420456 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: ID LCPC-7599) |
Additional Taxonomies | 101Y00000X Counselor (Licence: ID LPC-6545) |
101YM0800X Counselor, Mental Health (Licence: UT 13173266-6004) | |
101YP2500X Counselor, Professional (Licence: AZ LPC-23483) | |
101YP2500X Counselor, Professional (Licence: NV CP5540-R) | |
Enumeration Date | 2017-07-17 |
Last Update Date | 2024-12-09 |