NPI | 1528344884 |
---|---|
Former Name | STACEY DANSBERRY HIGGINS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2011035777) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CA 9910) |
Enumeration Date | 2011-10-31 |
Last Update Date | 2022-07-21 |