NPI | 1194367631 |
---|---|
Former Name | ASHLEY AMBER THOMAS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA 1194367631) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA 61017164) |
Enumeration Date | 2019-10-16 |
Last Update Date | 2022-05-05 |