NPI | 1740728286 |
---|---|
Former Name | ARLILIAN TISDEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 178012499) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180.013560) |
Enumeration Date | 2017-02-04 |
Last Update Date | 2022-07-06 |