| NPI | 1720131782 |
|---|---|
| Former Name | SONJA ROCHELLE BUCKLES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC S9891) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 9891) |
| 101YP2500X Counselor, Professional (Licence: NC 9891) | |
| Enumeration Date | 2007-01-20 |
| Last Update Date | 2020-09-16 |