NPI | 1427171909 |
---|---|
Former Name | PHYLLIS MONTROSE DARDEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: HI 44486) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 2825) |
101YM0800X Counselor, Mental Health (Licence: HI MHC-621) | |
Enumeration Date | 2007-04-09 |
Last Update Date | 2023-03-06 |