NPI | 1033697768 |
---|---|
Former Name | JENELLE M'LOU BRAUN-MONEGAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor (Licence: OR C6324) |
Additional Taxonomies | 103TS0200X Psychologist, School (Licence: OR TSPC10501134) |
101Y00000X Counselor (Licence: OR C4926) | |
103TC1900X Psychologist, Counseling (Licence: OR C4926) | |
Enumeration Date | 2018-08-03 |
Last Update Date | 2022-03-15 |