NPI | 1477890531 |
---|---|
Former Name | THERESA M BANAS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA CO161724L) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: SC 7933) |
101YP2500X Counselor, Professional (Licence: PA PC006724) | |
Enumeration Date | 2013-01-09 |
Last Update Date | 2022-04-12 |