NPI | 1508182403 |
---|---|
Former Name | ALISHA BATES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: OH E.0602251) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: KS 2122) |
Enumeration Date | 2010-04-16 |
Last Update Date | 2017-04-07 |