NPI | 1720511959 |
---|---|
Former Name | BREANN BEARDSLEE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor Mental Health |
Additional Taxonomies | 101YP2500X Counselor Professional (Licence: PA PC013758P) |
101YP2500X Counselor Professional (Licence: CT 4701) | |
Enumeration Date | 2017-04-05 |
Last Update Date | 2022-01-21 |