NPI | 1710413521 |
---|---|
Former Name | CASSANDRA LEIGH BRADLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.0015470) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO LPCC.0015243) |
Enumeration Date | 2017-05-11 |
Last Update Date | 2019-07-24 |