NPI | 1588863229 |
---|---|
Former Name | DIANE CELIA ROSS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: CA 45269) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 45269) |
Enumeration Date | 2007-07-12 |
Last Update Date | 2007-07-12 |