NPI | 1639461270 |
---|---|
Former Name | AMANDA MARIE BOLLINGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AR P1403036) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
101YM0800X Counselor, Mental Health (Licence: AR A1104040) | |
Enumeration Date | 2011-05-13 |
Last Update Date | 2018-05-14 |