NPI | 1164959730 |
---|---|
Former Name | ARIANNA ELIZABETH SPARKS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: SD 588) |
Additional Taxonomies | 101Y00000X Counselor (Licence: NE 11157) |
101Y00000X Counselor (Licence: NE 5186) | |
103T00000X Psychologist (Licence: NE 583) | |
Enumeration Date | 2017-05-15 |
Last Update Date | 2022-07-21 |