| NPI | 1063800308 |
|---|---|
| Former Name | MOLLY PANICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OK 7104) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2015-01-08 |
| Last Update Date | 2020-10-26 |