NPI | 1255064317 |
---|---|
Former Name | MIRANDA ELIZABETH PATRICK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TN 5104) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TN 5104) |
Enumeration Date | 2022-07-06 |
Last Update Date | 2024-01-23 |