NPI | 1508088998 |
---|---|
Former Name | DEBRA LYNNELLE LEACH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OK 4555) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2007-05-03 |
Last Update Date | 2023-06-08 |