NPI | 1245742535 |
---|---|
Former Name | CARA C NELLES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 39003618A) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180.011114) |
106H00000X Marriage & Family Therapist (Licence: IL 208.000440) | |
Enumeration Date | 2017-10-26 |
Last Update Date | 2020-11-30 |