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 |