| NPI | 1356662449 |
|---|---|
| Former Name | PAMELA WATERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH10100) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 17591) |
| Enumeration Date | 2010-06-12 |
| Last Update Date | 2010-06-12 |