| NPI | 1316396260 |
|---|---|
| Former Name | JAN ELAINE LAIL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 12039) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC A12039) |
| Enumeration Date | 2016-06-10 |
| Last Update Date | 2023-04-06 |