NPI | 1295239671 |
---|---|
Former Name | FREDA A MCCANTS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 1999136664) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MO 030489) |
Enumeration Date | 2018-03-21 |
Last Update Date | 2022-02-08 |