NPI | 1811537376 |
---|---|
Former Name | DEIDRE ISAAC |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 3131) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 5248) |
1041C0700X Social Worker, Clinical (Licence: NE 1803) | |
Enumeration Date | 2020-01-13 |
Last Update Date | 2023-07-31 |