NPI | 1013613892 |
---|---|
Former Name | SANDRA SUSAN OKRONGLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 149019468) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: IL 149019468) |
Enumeration Date | 2023-02-03 |
Last Update Date | 2025-01-16 |