| NPI | 1841410537 |
|---|---|
| Former Name | MILDRED ALICE LOCKARD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: KY 1496) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2014-06-17 |