NPI | 1023581428 |
---|---|
Former Name | ANGEL DIXON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA MC61091534) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2019-01-08 |
Last Update Date | 2021-08-03 |