NPI | 1871852657 |
---|---|
Former Name | LISA MICHELLE STANTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TX 65257) |
Additional Taxonomies | 103TS0200X Psychologist, School (Licence: TX 33446) |
Enumeration Date | 2012-05-14 |
Last Update Date | 2015-09-24 |