| NPI | 1609161546 |
|---|---|
| Former Name | TAKISHA FENA ANDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC A8234) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC 8234) |
| Enumeration Date | 2011-06-17 |
| Last Update Date | 2013-01-04 |