NPI | 1710154018 |
---|---|
Former Name | AMY LEE BRANSCUM |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.0012016) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
101YM0800X Counselor, Mental Health | |
Enumeration Date | 2008-05-15 |
Last Update Date | 2014-12-09 |