NPI | 1851714760 |
---|---|
Former Name | LISA LYNN GUTTERMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 6950) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: HI 190) |
101YP2500X Counselor, Professional (Licence: IL 180.008312) | |
101YP2500X Counselor, Professional (Licence: IL 178.003522) | |
Enumeration Date | 2014-01-28 |
Last Update Date | 2014-01-28 |