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