NPI | 1508308727 |
---|---|
Former Name | SHELLY HOLLAND |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 72581) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 72581) |
Enumeration Date | 2016-11-07 |
Last Update Date | 2019-12-31 |