NPI | 1417443573 |
---|---|
Former Name | SYDNEY CATHERINE ELLIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: TX 81902) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 14454) |
Enumeration Date | 2018-07-02 |
Last Update Date | 2024-05-27 |