NPI | 1093304149 |
---|---|
Former Name | REBECCA JORDAN CHENEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor (Licence: AZ LPC-21526) |
Additional Taxonomies | 101Y00000X Counselor (Licence: AZ 16875) |
Enumeration Date | 2021-01-13 |
Last Update Date | 2022-11-29 |