NPI | 1699312835 |
---|---|
Former Name | KATHERINE PITLOCK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180.012310) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 180012310) |
Enumeration Date | 2019-12-06 |
Last Update Date | 2024-07-03 |