NPI | 1558961904 |
---|---|
Former Name | TERESA LYNN MAYFIELD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 101Y00000X Counselor |
101YP2500X Counselor, Professional | |
Enumeration Date | 2020-10-27 |
Last Update Date | 2020-10-27 |