NPI | 1740065937 |
---|---|
Former Name | FEHEMA LUTRICIA JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YS0200X Counselor, School (Licence: MD LGP14136) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LGP14136) |
Enumeration Date | 2023-08-28 |
Last Update Date | 2023-08-28 |