| 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 |