| NPI | 1598961542 |
|---|---|
| Former Name | SHADALE NICOLE WOOD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC A8910) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2007-06-26 |
| Last Update Date | 2022-02-03 |