NPI | 1558032862 |
---|---|
Former Name | DEANDRA CASADOS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC11357) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LC11357) |
Enumeration Date | 2021-09-26 |
Last Update Date | 2024-11-03 |