NPI | 1457987943 |
---|---|
Former Name | MADELINE DESLONDE SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: LPC013657) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: GA APC007223) |
Enumeration Date | 2020-03-17 |
Last Update Date | 2024-05-01 |