NPI | 1144005596 |
---|---|
Former Name | AMY HAYDEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MN cc04317) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2023-08-25 |
Last Update Date | 2024-10-24 |