NPI | 1740570704 |
---|---|
Former Name | KEELY E COVERDELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ID 6157) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: ID 6157) |
101YP2500X Counselor, Professional (Licence: VA 0701004888) | |
Enumeration Date | 2011-04-12 |
Last Update Date | 2024-12-06 |