| NPI | 1891353090 |
|---|---|
| Former Name | LISIANE GONCALVES FIDALGO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: FL MH20225) |
| Enumeration Date | 2019-06-03 |
| Last Update Date | 2024-05-07 |