| NPI | 1841859394 |
|---|---|
| Former Name | TICHINA MONIQUE MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180014204) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 178011843) |
| Enumeration Date | 2019-06-09 |
| Last Update Date | 2023-05-17 |