| NPI | 1790164192 |
|---|---|
| Former Name | LANIECE CHEVETTE LEACH-AJAVON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: SC 10382) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor Mental Health | |
| 101YM0800X Counselor Mental Health (Licence: SC 10382) | |
| 101YP2500X Counselor Professional | |
| Enumeration Date | 2015-05-19 |
| Last Update Date | 2025-01-25 |