NPI | 1699052217 |
---|---|
Former Name | ASHLEY REYNOLDS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 6343) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: ME CC7194) |
101YP2500X Counselor, Professional (Licence: CO LPC.0019622) | |
Enumeration Date | 2011-11-10 |
Last Update Date | 2024-03-04 |