NPI | 1285756544 |
---|---|
Former Name | LESLIE JEAN BOHRER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 2082) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NE 1193) |
Enumeration Date | 2007-04-05 |
Last Update Date | 2007-07-08 |