| NPI | 1578232112 |
|---|---|
| Former Name | VICTORIA LYNN MASSIE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 171M00000X Case Manager/Care Coordinator | |
| 172V00000X Community Health Worker | |
| Enumeration Date | 2021-09-08 |
| Last Update Date | 2023-03-03 |