NPI | 1124447693 |
---|---|
Former Name | DAVINA FESSLER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NE 2622) |
Additional Taxonomies | 101Y00000X Counselor (Licence: NE 11674) |
101YM0800X Counselor, Mental Health (Licence: NE 2496) | |
Enumeration Date | 2014-04-14 |
Last Update Date | 2020-09-21 |