NPI | 1114200888 |
---|---|
Former Name | MELISSA M RICHARDSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 63513) |
Additional Taxonomies | 101Y00000X Counselor (Licence: TX 63513) |
101YP2500X Counselor, Professional (Licence: TX 63513) | |
Enumeration Date | 2011-09-20 |
Last Update Date | 2020-06-11 |