NPI | 1700097870 |
---|---|
Former Name | TARA GROSS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C2437) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist |
101YM0800X Counselor, Mental Health | |
Enumeration Date | 2007-05-24 |
Last Update Date | 2012-02-16 |