NPI | 1033522081 |
---|---|
Former Name | RENEE STALKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E.0900326) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: VA 0701005904) |
Enumeration Date | 2014-06-07 |
Last Update Date | 2018-07-11 |