| NPI | 1144906280 |
|---|---|
| Former Name | OTESSA EDMONDS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701012549) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VA 0701012549) |
| Enumeration Date | 2023-06-23 |
| Last Update Date | 2023-12-18 |