NPI | 1699287672 |
---|---|
Former Name | ALYSSA J. BROOK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: ID LCPC-10540) |
Additional Taxonomies | 101Y00000X Counselor (Licence: ID LPC-6717) |
Enumeration Date | 2017-10-30 |
Last Update Date | 2024-05-30 |