| NPI | 1235565672 |
|---|---|
| Former Name | TRACEY JEAN ENSMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH60561548) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WA CG60414889) |
| 101YM0800X Counselor, Mental Health (Licence: WA CG60414889) | |
| Enumeration Date | 2013-09-17 |
| Last Update Date | 2020-02-12 |