NPI | 1952839862 |
---|---|
Professional Name | N/A N/A |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH60801971) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 180010852) |
101YP2500X Counselor, Professional (Licence: IL 180010852) | |
Enumeration Date | 2017-05-23 |
Last Update Date | 2018-10-30 |