NPI | 1861014797 |
---|---|
Former Name | SAVANNAH JANE MARINO |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 14231) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC A14231) |
Enumeration Date | 2020-05-14 |
Last Update Date | 2022-03-27 |