| NPI | 1053072520 |
|---|---|
| Former Name | SHELBI RAELYNNE TIDD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 39004402A) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 88001233A) |
| 221700000X Art Therapist | |
| Enumeration Date | 2022-01-06 |
| Last Update Date | 2023-02-27 |