| NPI | 1699166223 |
|---|---|
| Former Name | VICTORIA JEAN THOMPSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NH 4817) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VA 0701006498) |
| Enumeration Date | 2015-02-18 |
| Last Update Date | 2024-12-03 |