NPI | 1457754251 |
---|---|
Former Name | DANIELLE CHRISTINE PROCTOR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NH 2071) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NH 9502) |
101YP2500X Counselor, Professional (Licence: WI 5435-125) | |
Enumeration Date | 2014-10-07 |
Last Update Date | 2018-08-15 |