NPI | 1558582676 |
---|---|
Former Name | EMILY LAUREN TILLETT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KY 102195) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
101YM0800X Counselor, Mental Health (Licence: KY 1308) | |
Enumeration Date | 2007-05-02 |
Last Update Date | 2016-08-12 |