NPI | 1407155732 |
---|---|
Former Name | JILL POTTER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA MC61334530) |
Additional Taxonomies | 172M00000X Mechanotherapist (Licence: WA MA60196732) |
Enumeration Date | 2011-03-25 |
Last Update Date | 2022-11-07 |