NPI | 1598190746 |
---|---|
Former Name | VALJEANNE PATRICE ROSS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH14414) |
Additional Taxonomies | 222Q00000X Developmental Therapist |
Enumeration Date | 2013-09-06 |
Last Update Date | 2018-08-13 |