NPI | 1437417714 |
---|---|
Former Name | CANDACE W ROSS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MI 6301015853) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI 6401007436) |
Enumeration Date | 2012-04-24 |
Last Update Date | 2020-11-19 |