| NPI | 1386201531 |
|---|---|
| Former Name | MALLORY CAMPBELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: TN TN3834) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health (Licence: TN TN3834) | |
| 101YP2500X Counselor, Professional (Licence: TN TN3834) | |
| Enumeration Date | 2019-05-23 |
| Last Update Date | 2020-06-02 |