NPI | 1215561162 |
---|---|
Former Name | ITHACA A. GILBERT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AL LPC04612) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AL C3455A) |
Enumeration Date | 2020-03-01 |
Last Update Date | 2023-10-16 |