NPI | 1700970969 |
---|---|
Former Name | GLORIA JEAN SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2006-10-03 |
Last Update Date | 2007-07-08 |