| NPI | 1366711939 |
|---|---|
| Former Name | TINA YVONNE MITCHELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 178.006219) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: IL 178.006219) |
| 101YM0800X Counselor, Mental Health (Licence: IL 178.006219) | |
| 101YS0200X Counselor, School (Licence: IL 2341716) | |
| 106H00000X Marriage & Family Therapist (Licence: IL 178.006219) | |
| Enumeration Date | 2011-12-27 |
| Last Update Date | 2011-12-27 |