NPI | 1548851967 |
---|---|
Former Name | MACY ELAINE PAWELEK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WV 2811) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 78295) |
Enumeration Date | 2021-01-28 |
Last Update Date | 2023-07-12 |