| NPI | 1124572946 |
|---|---|
| Former Name | ELIZABETH ROSE BURLESON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: NC 1902) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NC 11064A) |
| Enumeration Date | 2016-08-10 |
| Last Update Date | 2019-11-05 |