NPI | 1760878292 |
---|---|
Former Name | STEPHANIE SCHOVILLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO 0012373) |
Additional Taxonomies | 101YP2500X Counselor, Professional |
Enumeration Date | 2015-04-10 |
Last Update Date | 2023-02-14 |