NPI | 1538618582 |
---|---|
Former Name | AMBER SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO 0015072) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO LPCC.0014869) |
Enumeration Date | 2016-09-30 |
Last Update Date | 2019-06-24 |