NPI | 1295806339 |
---|---|
Former Name | JUDITH ANN WHITE-O'BRYANT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MI 6401005003) |
Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6401005003) |
103T00000X Psychologist (Licence: MI 6301008661) | |
103TC1900X Psychologist, Counseling (Licence: MI 6301008661) | |
Enumeration Date | 2006-11-12 |
Last Update Date | 2018-05-23 |