| NPI | 1871149658 |
|---|---|
| Former Name | MARLEE JANE BURROUGHS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC10183) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VA 0701008409) |
| Enumeration Date | 2019-08-16 |
| Last Update Date | 2021-06-01 |