| NPI | 1477093854 |
|---|---|
| Former Name | BECKA RAE GLEASON OR SWANKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MT BBH-LCPC-LIC-23177) |
| Additional Taxonomies | 251300000X Local Education Agency (LEA) (Licence: MT SWP-LCPC-LIC-11538) |
| Enumeration Date | 2017-03-03 |
| Last Update Date | 2017-03-06 |