| NPI | 1376983387 |
|---|---|
| Former Name | THERESA DENISE EVERETT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC20270) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 178.007134) |
| 101YM0800X Counselor, Mental Health (Licence: MI PC6401019591) | |
| 101YP2500X Counselor, Professional (Licence: IL 178.007134) | |
| Enumeration Date | 2013-07-05 |
| Last Update Date | 2022-08-17 |