NPI | 1356726251 |
---|---|
Former Name | MADELYN GRACE ESPOSITO-SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 5746 - 125) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2015-07-21 |
Last Update Date | 2024-03-28 |