NPI | 1245055672 |
---|---|
Former Name | STARSHA LYNN TRUESDALE |
Entity Type | Individual |
Gender | N/A |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 83182) |
Additional Taxonomies | 101YP2500X Counselor, Professional |
Enumeration Date | 2024-11-20 |
Last Update Date | 2025-01-13 |