| NPI | 1407227127 |
|---|---|
| Former Name | BREANNA POLK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 82700) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2015-10-08 |
| Last Update Date | 2025-02-22 |