NPI | 1285151076 |
---|---|
Former Name | SANTANA NIKCOLE DALTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor Professional (Licence: TN 5911) |
Additional Taxonomies | 101YM0800X Counselor Mental Health |
Enumeration Date | 2017-08-23 |
Last Update Date | 2022-08-05 |