NPI | 1417493719 |
---|---|
Former Name | ELIZABETH CHRISTIANE JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C4394) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR C4394) |
Enumeration Date | 2017-01-10 |
Last Update Date | 2020-03-05 |