| NPI | 1215577382 |
|---|---|
| Former Name | BROOKE BLYTHE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MO 2019047962) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MO 2019047962) |
| Enumeration Date | 2020-01-07 |
| Last Update Date | 2023-12-26 |