| NPI | 1437276912 |
|---|---|
| Former Name | CYNTHIA DIANNE HAIRSTON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH12217) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR C8241) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2024-07-30 |