NPI | 1609270834 |
---|---|
Former Name | LORENE KING |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NM CCMH0183461) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NM 0183461) |
Enumeration Date | 2014-10-17 |
Last Update Date | 2019-09-30 |