| NPI | 1063648582 |
|---|---|
| Former Name | MARY ELLEN BRYANT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NC 2311) |
| Additional Taxonomies | 101YS0200X Counselor School |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2010-03-15 |