NPI | 1861046385 |
---|---|
Former Name | LACEY FREEMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: TX 69531) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: TX 69531) |
Enumeration Date | 2019-08-01 |
Last Update Date | 2019-08-01 |