| NPI | 1013550813 |
|---|---|
| Former Name | REBECCA MOODY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 8411-125) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 4425-226) |
| Enumeration Date | 2019-10-24 |
| Last Update Date | 2022-01-12 |