NPI | 1417274655 |
---|---|
Former Name | SHAUNTA GILLS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor |
Additional Taxonomies | 101Y00000X Counselor (Licence: OK 5917) |
Enumeration Date | 2010-04-28 |
Last Update Date | 2020-01-14 |