NPI | 1417164344 |
---|---|
Former Name | STACY LACOLE SALMON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 10113) |
Enumeration Date | 2007-05-17 |
Last Update Date | 2022-10-24 |