NPI | 1912425075 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E.1901039) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH E.1901039-SUPV) |
101YP2500X Counselor, Professional (Licence: AZ LPC-20057) | |
Enumeration Date | 2017-09-08 |
Last Update Date | 2023-03-28 |