NPI | 1124342001 |
---|---|
Former Name | IVORY SHAE CARTER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY 104689) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 99128083A) |
Enumeration Date | 2010-03-21 |
Last Update Date | 2024-11-04 |