| NPI | 1902316987 |
|---|---|
| Former Name | GWEN HUMBLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CA 8252) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2017-10-04 |
| Last Update Date | 2020-12-10 |