| NPI | 1003302738 |
|---|---|
| Former Name | MARIAH ANN EDWARDS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: LPC.0016772) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO LPCC.0016182) |
| Enumeration Date | 2018-07-05 |
| Last Update Date | 2021-10-04 |