| NPI | 1528158979 |
|---|---|
| Former Name | TANDY R PEA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34004789A) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: IN 34004789A) |
| 101YM0800X Counselor, Mental Health (Licence: IN 34004789A) | |
| Enumeration Date | 2006-10-14 |
| Last Update Date | 2023-10-07 |