NPI | 1356463012 |
---|---|
Former Name | CYNTHIA MARIE BRUNNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 3759) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH 60522568) |
Enumeration Date | 2007-04-04 |
Last Update Date | 2015-06-03 |