NPI | 1114568102 |
---|---|
Former Name | REBECCA DOBERSTEIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC LPC7315) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: GA LPC010718) |
101YP2500X Counselor, Professional (Licence: GA LPC010718) | |
Enumeration Date | 2019-10-01 |
Last Update Date | 2023-02-27 |