NPI | 1740945880 |
---|---|
Former Name | STEPHANIE POWERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180013929) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180013929) |
Enumeration Date | 2021-11-03 |
Last Update Date | 2025-02-03 |