| NPI | 1689749459 |
|---|---|
| Former Name | ANGELA MARIE BAGWELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH00007711) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2023-07-10 |