| NPI | 1356744528 |
|---|---|
| Former Name | LORA CHASTAIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OK 5527) |
| Additional Taxonomies | 101YP2500X Counselor, Professional |
| Enumeration Date | 2014-10-02 |
| Last Update Date | 2019-05-20 |