NPI | 1356734313 |
---|---|
Former Name | CARIE SHIELDS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C6905) |
Additional Taxonomies | 225700000X Massage Therapist (Licence: OR 5523) |
Enumeration Date | 2015-03-13 |
Last Update Date | 2022-07-18 |