NPI | 1609566553 |
---|---|
Former Name | BREANNA MAUREEN MCMILLAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH25818) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL IMH23990) |
Enumeration Date | 2023-05-12 |
Last Update Date | 2025-06-03 |