NPI | 1407515323 |
---|---|
Former Name | CORDAY DENISE BRADLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC A16971) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 16971) |
Enumeration Date | 2021-12-08 |
Last Update Date | 2024-09-04 |