NPI | 1396024022 |
---|---|
Former Name | KAREN BRIDGES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 175F00000X Naturopath (Licence: AZ 11-1256) |
Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: LPC-12926) |
101YP2500X Counselor Professional (Licence: AZ LPC-12926) | |
Enumeration Date | 2011-08-11 |
Last Update Date | 2014-10-24 |