NPI | 1255956355 |
---|---|
Former Name | PAMELA STARK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: OH CDCA.171649) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2020-06-15 |
Last Update Date | 2020-06-15 |