| NPI | 1669920328 |
|---|---|
| Former Name | NICOLE RENEE ESHENAUR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist Clinical (Licence: PA PS018590) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2016-09-12 |
| Last Update Date | 2018-10-23 |