| NPI | 1215795166 |
|---|---|
| Former Name | NICOLE SHAVER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AL 6497G) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: AK 6497G) |
| Enumeration Date | 2024-03-06 |
| Last Update Date | 2024-03-06 |