NPI | 1730572207 |
---|---|
Former Name | TONYA SANTOS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ME cc4868) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ME XL4416) |
Enumeration Date | 2015-03-09 |
Last Update Date | 2024-06-25 |