| NPI | 1588861702 |
|---|---|
| Former Name | CHARLENE PENDLETON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NM 0163621) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MO 2007018129) |
| 101YM0800X Counselor, Mental Health (Licence: NM T-0153331) | |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2015-02-20 |