NPI | 1538517552 |
---|---|
Former Name | ASHLEY NICOLE MOULTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 121965) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2016-05-31 |
Last Update Date | 2020-10-29 |