NPI | 1962111583 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH25801) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL IMH19661) |
Enumeration Date | 2022-11-22 |
Last Update Date | 2025-08-12 |