NPI | 1376932525 |
---|---|
Former Name | LISA MARIE BORJA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C4266) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA LH61604402) |
Enumeration Date | 2015-01-12 |
Last Update Date | 2025-09-17 |