NPI | 1871959585 |
---|---|
Former Name | LATISHA JOLENE CRESON-BEATY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2015043559) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MO 2015043559) |
101Y00000X Counselor (Licence: MO 2015043559) | |
Enumeration Date | 2016-01-11 |
Last Update Date | 2024-10-15 |