NPI | 1457024010 |
---|---|
Former Name | CHANTA C WALTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 81170) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 81170) |
Enumeration Date | 2021-07-29 |
Last Update Date | 2024-06-03 |