| NPI | 1053683003 |
|---|---|
| Former Name | SUSAN THOMPSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 296834) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2012-02-07 |
| Last Update Date | 2022-06-17 |