NPI | 1154041549 |
---|---|
Former Name | RAGON DAWN MCBRIDE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AR A2208022) |
Enumeration Date | 2022-08-29 |
Last Update Date | 2023-10-10 |