NPI | 1790103224 |
---|---|
Former Name | AUDREY MOORE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ME CC5017) |
Additional Taxonomies | 101Y00000X Counselor (Licence: ME CC5017) |
101YM0800X Counselor, Mental Health | |
101YS0200X Counselor, School (Licence: TN 000591828) | |
Enumeration Date | 2014-04-01 |
Last Update Date | 2024-06-06 |