NPI | 1629123450 |
---|---|
Former Name | MARY ANN LITTLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: SC LPC9136) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IA LMHC39004878A) |
101YM0800X Counselor, Mental Health (Licence: FL LMHC7711) | |
101YM0800X Counselor, Mental Health (Licence: FL MH7711) | |
Enumeration Date | 2007-01-24 |
Last Update Date | 2024-04-02 |