| NPI | 1568090470 |
|---|---|
| Former Name | GELISA SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH C.2002873) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH C.1901879-TRNE) |
| Enumeration Date | 2020-03-28 |
| Last Update Date | 2020-12-23 |