| NPI | 1104396704 |
|---|---|
| Former Name | LAUREN MCKENZIE MONGONIA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: TX 88877) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: OH C.2002643) |
| Enumeration Date | 2018-11-27 |
| Last Update Date | 2023-05-18 |