NPI | 1447294061 |
---|---|
Former Name | SHANNON ALISON HARTMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 4390) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NC 963) |
106H00000X Marriage & Family Therapist (Licence: CA 39135) | |
Enumeration Date | 2006-06-15 |
Last Update Date | 2007-07-08 |