NPI | 1043805351 |
---|---|
Former Name | NICOLLE R WOMACK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC15245) |
Additional Taxonomies | 101Y00000X Counselor (Licence: MD LC15245) |
101YM0800X Counselor, Mental Health (Licence: MD LC15245) | |
Enumeration Date | 2021-03-08 |
Last Update Date | 2024-06-27 |