NPI | 1710538921 |
---|---|
Former Name | MONICA RENEE HADDOCK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OK 8199) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2019-09-28 |
Last Update Date | 2022-12-30 |