| NPI | 1679226195 |
|---|---|
| Former Name | MARIAH BRUNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 39004388A) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IN 88001251A) |
| Enumeration Date | 2022-02-03 |
| Last Update Date | 2023-01-20 |