| NPI | 1023370962 |
|---|---|
| Former Name | NICOLE ROSS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2012-06-15 |
| Last Update Date | 2020-10-09 |