| NPI | 1154016152 |
|---|---|
| Former Name | ELIZABETH SURRATT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2023-04-06 |
| Last Update Date | 2023-04-06 |