NPI | 1568921906 |
---|---|
Former Name | BETHANY LEE BURTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC011055) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: DE PC-0011379) |
Enumeration Date | 2019-03-15 |
Last Update Date | 2023-02-23 |