NPI | 1730564485 |
---|---|
Former Name | RAINISHA LA VERNE BRADLEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 70918) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 70918) |
Enumeration Date | 2015-07-23 |
Last Update Date | 2023-01-27 |