NPI | 1215693189 |
---|---|
Former Name | TAYLOR NICOLE DECKARD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OK 12765) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 82929) |
Enumeration Date | 2021-11-15 |
Last Update Date | 2025-07-22 |