NPI | 1780016733 |
---|---|
Former Name | ANNIE LAURA MCSHANE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MS 1981) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2013-08-01 |
Last Update Date | 2015-04-28 |