NPI | 1700913803 |
---|---|
Former Name | JAMIE BUNCH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2007014793) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist |
Enumeration Date | 2007-02-27 |
Last Update Date | 2007-09-24 |