NPI | 1073960795 |
---|---|
Former Name | MAKAYLA BURKMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA 13852) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: UT 11697949-6004) |
101YM0800X Counselor, Mental Health (Licence: ID LCPC-7003) | |
101YM0800X Counselor, Mental Health (Licence: ID LPC - 6171) | |
Enumeration Date | 2016-05-23 |
Last Update Date | 2024-09-25 |