NPI | 1083929533 |
---|---|
Former Name | MAYRENA HANSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 10012) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 000010012) |
Enumeration Date | 2010-08-09 |
Last Update Date | 2022-08-18 |