NPI | 1558796060 |
---|---|
Former Name | JOANNA MOGAVERO CLEKIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH4173) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: SC LPC 893) |
Enumeration Date | 2013-09-04 |
Last Update Date | 2013-09-04 |