NPI | 1285172338 |
---|---|
Former Name | SHANNON RENE ABBOTT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401017357) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6401015889) |
101YM0800X Counselor, Mental Health (Licence: MI 6401017357) | |
Enumeration Date | 2017-02-09 |
Last Update Date | 2023-11-03 |