NPI | 1063052298 |
---|---|
Former Name | LEANNE DEISTER-GOODWIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 178017418) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180016270) |
Enumeration Date | 2020-01-15 |
Last Update Date | 2024-08-23 |