NPI | 1154669042 |
---|---|
Former Name | AMANDA LEE BUNTIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OK 06011) |
Additional Taxonomies | 101YP2500X Counselor, Professional |
Enumeration Date | 2013-01-28 |
Last Update Date | 2025-06-03 |