NPI | 1386033959 |
---|---|
Former Name | LANE KIMBERLY HAWES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 8114) |
Additional Taxonomies | 101YS0200X Counselor, School (Licence: NC SP II) |
101YP2500X Counselor, Professional (Licence: NC 8114) | |
Enumeration Date | 2015-01-20 |
Last Update Date | 2021-09-12 |