NPI | 1356432579 |
---|---|
Former Name | AMANDA COREEN BOWERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701002570) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: VA 0717000300) |
Enumeration Date | 2006-09-27 |
Last Update Date | 2024-04-17 |