NPI | 1376144766 |
---|---|
Former Name | ARLICIA JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC014828) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC A17760) |
Enumeration Date | 2020-11-03 |
Last Update Date | 2024-07-25 |