NPI | 1639519234 |
---|---|
Former Name | BRITTANY JANNA BUNDY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: KY 104084) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KY 1224) |
Enumeration Date | 2013-06-27 |
Last Update Date | 2023-07-27 |