NPI | 1720453475 |
---|---|
Former Name | CARLA MONIQUE MCLEOD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA 12017) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: TX 89309) |
101YM0800X Counselor, Mental Health (Licence: GA LPC007367) | |
Enumeration Date | 2015-12-07 |
Last Update Date | 2023-10-17 |