NPI | 1568796712 |
---|---|
Former Name | MARLA J STEWART-MORENO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor Professional (Licence: OR C4003) |
Additional Taxonomies | 101YM0800X Counselor Mental Health |
Enumeration Date | 2009-09-21 |
Last Update Date | 2024-11-25 |