| NPI | 1932086642 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VA 0732006044) |
| Enumeration Date | 2025-08-18 |
| Last Update Date | 2025-08-18 |