| NPI | 1710497912 |
|---|---|
| Former Name | LISA TAYLOR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC9677) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LGP8009) |
| Enumeration Date | 2017-10-03 |
| Last Update Date | 2023-11-16 |