NPI | 1255493326 |
---|---|
Former Name | ROSE MARIE JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 20197) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 20197) |
Enumeration Date | 2006-12-15 |
Last Update Date | 2023-03-15 |