| NPI | 1760713721 |
|---|---|
| Former Name | CECILIA GAYE DIETZE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MT 50216) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OK 2869) |
| Enumeration Date | 2010-01-14 |
| Last Update Date | 2022-06-23 |