| NPI | 1356157366 |
|---|---|
| Former Name | SHELLEY CHRISTINE SISSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC015179) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: GA LPC015179) |
| Enumeration Date | 2024-12-04 |
| Last Update Date | 2024-12-04 |