NPI | 1780003681 |
---|---|
Former Name | MELISSA ANNE MATTHEWS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA LPCC922) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH E-0002989) |
Enumeration Date | 2014-04-08 |
Last Update Date | 2014-04-08 |