NPI | 1801824073 |
---|---|
Former Name | SUZANNE WAHLS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180-005332) |
Additional Taxonomies | 101Y00000X Counselor (Licence: IL 180-005332) |
101YP2500X Counselor, Professional (Licence: IL 180-005332) | |
Enumeration Date | 2006-06-28 |
Last Update Date | 2012-03-13 |