NPI | 1639668536 |
---|---|
Former Name | ANGELINA FAYE SHIREY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 13833) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
101YM0800X Counselor, Mental Health (Licence: 13833) | |
Enumeration Date | 2018-05-07 |
Last Update Date | 2024-01-10 |