NPI | 1265740054 |
---|---|
Former Name | CRYSTAL RUSK-TREMBLAY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY 174800) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OH E.1000088) |
Enumeration Date | 2010-09-15 |
Last Update Date | 2019-12-09 |