NPI | 1699049031 |
---|---|
Former Name | REBECCA MELLIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: PA PC010200) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: PA PC010200) |
Enumeration Date | 2012-03-02 |
Last Update Date | 2024-03-07 |