| NPI | 1225430333 |
|---|---|
| Former Name | CAROLYN MAY BURGESS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: CT 002318) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CT 002318) |
| Enumeration Date | 2014-09-19 |
| Last Update Date | 2021-09-16 |