NPI | 1972963585 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC LCMHC18324) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO LPC.0014692) |
Enumeration Date | 2016-02-25 |
Last Update Date | 2023-02-14 |