| NPI | 1679904361 |
|---|---|
| Former Name | CARRIE BEAVER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH E.1000112) |
| Enumeration Date | 2013-12-05 |
| Last Update Date | 2020-01-11 |