| NPI | 1144686619 |
|---|---|
| Former Name | LAUREN MELISSA CARLISLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AL 3526) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AL C2304A) |
| Enumeration Date | 2016-01-13 |
| Last Update Date | 2020-01-06 |