NPI | 1679906507 |
---|---|
Former Name | STACIE PAGE WELLS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C5681) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 75987) |
Enumeration Date | 2013-08-14 |
Last Update Date | 2024-05-11 |