NPI | 1588703136 |
---|---|
Former Name | COLLEEN PATRICIA DUGAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: SD LPC 626) |
Additional Taxonomies | 101Y00000X Counselor (Licence: SD LMFT 1120) |
Enumeration Date | 2007-02-06 |
Last Update Date | 2007-07-08 |