| NPI | 1265818769 |
|---|---|
| Former Name | CYNTHIA LEE NIST |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH3566) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: VA 070100785) |
| 101YP2500X Counselor Professional (Licence: VA 070100785) | |
| 101YP2500X Counselor Professional (Licence: FL MH3566) | |
| 101YS0200X Counselor School | |
| Enumeration Date | 2015-08-06 |
| Last Update Date | 2022-02-22 |