| NPI | 1497126882 |
|---|---|
| Former Name | SUSAN KATHRYN DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR C6868) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health (Licence: OR R4988) | |
| Enumeration Date | 2015-10-12 |
| Last Update Date | 2024-08-21 |