| NPI | 1043724792 |
|---|---|
| Former Name | ANGELA RUTH WILLOUGHBY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AZ LPC-15563) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: NJ 37PC00528700) |
| Enumeration Date | 2017-11-16 |
| Last Update Date | 2023-03-08 |