| NPI | 1164807343 |
|---|---|
| Former Name | CARRIE ANN GARDNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180.015912) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MO 2016040340) |
| Enumeration Date | 2015-07-29 |
| Last Update Date | 2025-06-13 |