| NPI | 1982153516 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 4806) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 2308) |
| Enumeration Date | 2016-09-23 |
| Last Update Date | 2016-09-23 |