NPI | 1912426297 |
---|---|
Former Name | MEGAN ANN SULLIVAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 13327) |
Additional Taxonomies | 101YP2500X Counselor, Professional |
Enumeration Date | 2017-09-18 |
Last Update Date | 2024-01-16 |