NPI | 1578011672 |
---|---|
Former Name | LESLIE MIRANDA BROWN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 70884) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 70884) |
Enumeration Date | 2016-09-17 |
Last Update Date | 2024-05-13 |