NPI | 1407561814 |
---|---|
Former Name | NATALEE STOCKDALE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MN 4040) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2023-01-19 |
Last Update Date | 2025-09-19 |