NPI | 1114581196 |
---|---|
Former Name | ROBIN WAGNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor (Licence: TX 77801) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 77801) |
101YP2500X Counselor, Professional (Licence: TX 77801) | |
101YS0200X Counselor, School (Licence: TX 1772725) | |
Enumeration Date | 2019-04-25 |
Last Update Date | 2024-08-21 |