| NPI | 1740945880 |
|---|---|
| Former Name | STEPHANIE POWERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180013929) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 180013929) |
| Enumeration Date | 2021-11-03 |
| Last Update Date | 2022-04-12 |