NPI | 1184158966 |
---|---|
Former Name | BRIANNA KATELYN BEDARD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC008371) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NM CTB-2022-0355) |
Enumeration Date | 2017-04-18 |
Last Update Date | 2023-03-22 |