NPI | 1548679285 |
---|---|
Former Name | RANDI REASON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 283Q00000X Psychiatric Hospital (Licence: CA 93437) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 73314) |
Enumeration Date | 2014-08-07 |
Last Update Date | 2023-01-14 |