NPI | 1164758736 |
---|---|
Former Name | BETHANY LEANNE LARIMORE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY 1053935) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: KY KY-0939) |
Enumeration Date | 2009-11-02 |
Last Update Date | 2023-11-15 |