NPI | 1841939303 |
---|---|
Former Name | TESSA LEONE MISKIMEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 10779125) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2022-06-02 |
Last Update Date | 2024-05-07 |