NPI | 1508137399 |
---|---|
Former Name | STEPHANIE GABRIELLE SUMNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KY KY-1597) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2012-01-25 |
Last Update Date | 2013-11-14 |