NPI | 1427559970 |
---|---|
Former Name | LAURYN MIZUHARA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC007778) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2018-02-21 |
Last Update Date | 2023-12-12 |