NPI | 1477914828 |
---|---|
Former Name | EMILY MARIE SHRADER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC008679) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MD LC6808) |
Enumeration Date | 2016-03-14 |
Last Update Date | 2023-10-08 |