NPI | 1548706310 |
---|---|
Former Name | NICOLE MONIQUE DODD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.0018125) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH17536) |
101YM0800X Counselor, Mental Health (Licence: FL IMH 14985) | |
Enumeration Date | 2017-01-17 |
Last Update Date | 2023-06-29 |