NPI | 1659867760 |
---|---|
Former Name | DEPRISE LYNN PRADO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: ID LCPC-8668) |
Additional Taxonomies | 101Y00000X Counselor (Licence: ID LPC-6921) |
Enumeration Date | 2018-07-02 |
Last Update Date | 2022-09-06 |