| NPI | 1902362361 |
|---|---|
| Former Name | CASSANDRA JANE MCCOY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA LPC011308) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: HI 765) |
| 101YM0800X Counselor, Mental Health (Licence: AL 4644) | |
| 101YM0800X Counselor, Mental Health (Licence: TX 84340) | |
| Enumeration Date | 2019-02-11 |
| Last Update Date | 2024-01-03 |