NPI | 1467985523 |
---|---|
Former Name | ANNA IZABELA TEMPLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor Professional (Licence: FL MH11118) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: FL MH11118) |
101YM0800X Counselor Mental Health (Licence: FL MH11118) | |
Enumeration Date | 2017-04-06 |
Last Update Date | 2021-03-25 |