NPI | 1912459587 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: ID LCPC-6828) |
Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: ID LPC-5927) |
Enumeration Date | 2016-10-31 |
Last Update Date | 2022-01-25 |