NPI | 1679233837 |
---|---|
Former Name | LAUREN ALICIA ELIZABAETH BROCKEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: AZ lpc-23086) |
Enumeration Date | 2021-12-28 |
Last Update Date | 2024-09-16 |