NPI | 1255444790 |
---|---|
Former Name | QUIANDA NICHELLE STANLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional |
Additional Taxonomies | 101Y00000X Counselor (Licence: VA 0710101764) |
101YP2500X Counselor, Professional (Licence: VA 0701003705) | |
Enumeration Date | 2006-08-17 |
Last Update Date | 2020-10-30 |