NPI | 1770138927 |
---|---|
Former Name | ABIGAIL ROSE CLOUDY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101Y00000X Counselor (Licence: TX 89203) |
Additional Taxonomies | 106S00000X Behavior Technician |
Enumeration Date | 2019-08-05 |
Last Update Date | 2023-07-11 |