NPI | 1831605674 |
---|---|
Former Name | CONNIE MERCER-COGBURN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO LPC.0016047) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO LPCC.0015765) |
Enumeration Date | 2017-12-15 |
Last Update Date | 2024-08-14 |