NPI | 1679704803 |
---|---|
Former Name | VICTORIA LYNN TEWA |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ 16273) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NM 0115211) |
Enumeration Date | 2009-08-05 |
Last Update Date | 2025-09-25 |