NPI | 1356589352 |
---|---|
Former Name | CHARLA ANN POORE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH6991) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: FL MH6991) |
Enumeration Date | 2009-01-29 |
Last Update Date | 2009-01-29 |