NPI | 1063804425 |
---|---|
Former Name | SUSANNAH GRACE MILNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: WA LH60801340) |
Additional Taxonomies | 101YP2500X Counselor Professional (Licence: LA 7068) |
101YP2500X Counselor Professional (Licence: KY 171745) | |
Enumeration Date | 2015-02-23 |
Last Update Date | 2018-04-11 |