NPI | 1104078666 |
---|---|
Former Name | GLORIA DAUGHTERY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC005336) |
Additional Taxonomies | 101Y00000X Counselor (Licence: GA LPC005336) |
101YM0800X Counselor, Mental Health (Licence: GA LPC005336) | |
Enumeration Date | 2008-10-15 |
Last Update Date | 2012-08-07 |