NPI | 1003245630 |
---|---|
Former Name | DESTINY E'SHUNDA THOMAS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA LPC008731) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: LA 8085) |
171M00000X Case Manager/Care Coordinator | |
Enumeration Date | 2013-11-04 |
Last Update Date | 2023-02-24 |