| NPI | 1578399309 |
|---|---|
| Former Name | COREY ALLEN SAMPSEL |
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: TX 113383) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2024-09-09 |
| Last Update Date | 2024-09-09 |