| NPI | 1528746195 |
|---|---|
| Former Name | ALIEA LOUISE WHITESIDES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WA CG61417161) |
| Enumeration Date | 2023-07-05 |
| Last Update Date | 2024-04-17 |