NPI | 1043582182 |
---|---|
Former Name | ASHLEY M TRAVIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NM 0174371) |
Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NM T-0146671) |
Enumeration Date | 2012-02-06 |
Last Update Date | 2017-04-28 |