| NPI | 1508415324 |
|---|---|
| Former Name | ASHLIE DESERAI BISHOP |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.0018447) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: KY 248641) |
| Enumeration Date | 2019-09-04 |
| Last Update Date | 2023-12-20 |