NPI | 1114104478 |
---|---|
Former Name | CECELIA MARIE NASH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA LPC004994) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA LPC004994) |
Enumeration Date | 2008-01-29 |
Last Update Date | 2024-03-26 |