NPI | 1235731597 |
---|---|
Former Name | AMBER ENDSLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2020036326) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MO 2020036326) |
Enumeration Date | 2020-11-12 |
Last Update Date | 2023-02-02 |