NPI | 1205277175 |
---|---|
Former Name | BEVERLY PARK-JEWELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA LPCC #326) |
Additional Taxonomies | 101Y00000X Counselor (Licence: CA LPCC326) |
Enumeration Date | 2013-07-08 |
Last Update Date | 2022-03-17 |