NPI | 1154097780 |
---|---|
Former Name | HEATHER MARIE HARRELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701013803) |
Additional Taxonomies | 101YP2500X Counselor, Professional |
Enumeration Date | 2021-08-23 |
Last Update Date | 2024-11-13 |