NPI | 1669037842 |
---|---|
Former Name | TAMARA BURKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: DC PRC15285) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VA 0701011899) |
101YM0800X Counselor, Mental Health (Licence: DE pc0011641) | |
101YP2500X Counselor, Professional (Licence: DC PRC15285) | |
Enumeration Date | 2019-05-03 |
Last Update Date | 2025-03-18 |