NPI | 1811290620 |
---|---|
Former Name | JONELLE LEE HANAWALT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC005543) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: PA PC005543) |
Enumeration Date | 2010-12-16 |
Last Update Date | 2025-02-05 |