| NPI | 1750588778 |
|---|---|
| Former Name | SANDRA CAROL BROSE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL 24188) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 180005930) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2024-11-18 |