NPI | 1124775507 |
---|---|
Former Name | MEGEN R BUKOWSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SD LPC-MH30658) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2022-03-07 |
Last Update Date | 2024-09-24 |