| NPI | 1932616885 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: PA PC015851) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VA 0701007278) |
| Enumeration Date | 2018-01-01 |
| Last Update Date | 2023-10-11 |