NPI | 1174721021 |
---|---|
Former Name | VICKIE LYNN PURDY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor Professional (Licence: SC 9468) |
Additional Taxonomies | 101YP2500X Counselor Professional (Licence: TX 18352) |
Enumeration Date | 2007-07-03 |
Last Update Date | 2024-02-14 |