| NPI | 1508304775 |
|---|---|
| Former Name | CHEYENNE CARROLL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AL 3993) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2017-02-07 |
| Last Update Date | 2019-01-07 |