NPI | 1164564167 |
---|---|
Former Name | KAREN MARIE DAVIDSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 2170) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 1007) |
Enumeration Date | 2007-02-13 |
Last Update Date | 2021-05-03 |