NPI | 1245471325 |
---|---|
Former Name | DEBRA ANN KING-JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor |
Additional Taxonomies | 101Y00000X Counselor (Licence: SC LPC 2838) |
101Y00000X Counselor (Licence: SC LPC/S 3689) | |
Enumeration Date | 2009-03-18 |
Last Update Date | 2019-02-20 |