NPI | 1851468383 |
---|---|
Former Name | TERRY LEE PERREAULT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CT 001640) |
Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: DE PC0000327) |
Enumeration Date | 2006-11-29 |
Last Update Date | 2008-06-23 |