NPI | 1134251036 |
---|---|
Former Name | SUZANNE EAGAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 7965) |
Additional Taxonomies | 225600000X Dance Therapist (Licence: MA BC-DMT 1060) |
Enumeration Date | 2007-03-09 |
Last Update Date | 2013-07-02 |