NPI | 1235605437 |
---|---|
Former Name | HEATHER LOCKETT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 4040-226) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 7658-125) |
Enumeration Date | 2018-10-16 |
Last Update Date | 2020-03-25 |