NPI | 1760733067 |
---|---|
Former Name | DONNAH MCCLAVE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KY 260504) |
Additional Taxonomies | 101Y00000X Counselor (Licence: KY 172345) |
101Y00000X Counselor | |
Enumeration Date | 2012-09-26 |
Last Update Date | 2020-01-09 |