NPI | 1417645987 |
---|---|
Former Name | SAMANTHA KOVAC |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180.016804) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 178.019041) |
Enumeration Date | 2023-04-24 |
Last Update Date | 2025-04-12 |