NPI | 1700116993 |
---|---|
Former Name | ROSEANNE LEE JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NY 083560-1) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2010-01-11 |
Last Update Date | 2016-10-17 |