NPI | 1801239538 |
---|---|
Former Name | LISSETTE MARIE COLON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH E.0800476-SUPV) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OH E.0800476) |
Enumeration Date | 2013-04-11 |
Last Update Date | 2016-10-10 |