| NPI | 1598983264 |
|---|---|
| Former Name | LIESHA MARIE ROBERTS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KY 1450) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY 0343) |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2014-06-16 |