NPI | 1720587850 |
---|---|
Former Name | AMY PARKS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH E.2102181) |
Additional Taxonomies | 101Y00000X Counselor (Licence: OH C.1700671-TRNE) |
Enumeration Date | 2018-02-05 |
Last Update Date | 2024-04-30 |