NPI | 1235682428 |
---|---|
Former Name | RANDEE BURKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY 260635) |
Additional Taxonomies | 101Y00000X Counselor (Licence: KY 260635) |
Enumeration Date | 2016-07-25 |
Last Update Date | 2025-09-04 |