NPI | 1639519234 |
---|---|
Former Name | BRITTANY JANNA BUNDY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional |
Additional Taxonomies | 101Y00000X Counselor (Licence: KY 104084) |
101YM0800X Counselor, Mental Health (Licence: KY 1224) | |
Enumeration Date | 2013-06-27 |
Last Update Date | 2025-02-11 |