NPI | 1386966018 |
---|---|
Former Name | DORLENE ELLLEN WALEHWA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA LPC009625) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MO 2009032852) |
Enumeration Date | 2010-02-22 |
Last Update Date | 2018-03-17 |