NPI | 1700409869 |
---|---|
Former Name | BREANNE LEAH HALL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL 17550) |
Additional Taxonomies | 101Y00000X Counselor (Licence: GA 007887) |
101Y00000X Counselor (Licence: FL 17550) | |
Enumeration Date | 2020-05-24 |
Last Update Date | 2025-05-06 |