| NPI | 1821565482 |
|---|---|
| Former Name | MEGAN REBEKA ROBERTS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH18776) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: FL IMH17724) |
| Enumeration Date | 2018-10-31 |
| Last Update Date | 2023-07-24 |