NPI | 1679965438 |
---|---|
Former Name | TARRA LANE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL IMH21446) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2015-03-03 |
Last Update Date | 2022-08-17 |