| NPI | 1316521883 |
|---|---|
| Former Name | AMY VANESSA GLICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA 25932) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YM0800X Counselor, Mental Health (Licence: CA 273425) | |
| Enumeration Date | 2021-05-10 |
| Last Update Date | 2023-04-20 |