NPI | 1528506912 |
---|---|
Former Name | TEDESSA WHITNEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: NY 091900) |
Additional Taxonomies | 101Y00000X Counselor (Licence: NY 090153) |
Enumeration Date | 2017-02-06 |
Last Update Date | 2021-09-15 |