NPI | 1811331309 |
---|---|
Former Name | GENNIE BROTHERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MA 10413) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CT 003275) |
Enumeration Date | 2013-04-26 |
Last Update Date | 2024-09-06 |