NPI | 1457821704 |
---|---|
Former Name | HEIDI J GOUGH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor (Licence: WA CG60918190) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: WA CG60918190) |
Enumeration Date | 2018-11-29 |
Last Update Date | 2021-04-05 |