| NPI | 1841518149 |
|---|---|
| Former Name | COURTNEY BLYTHE WALTERS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: NC 7375) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NC 7375) |
| Enumeration Date | 2010-05-11 |
| Last Update Date | 2023-01-25 |