NPI | 1922581396 |
---|---|
Former Name | TAMARA ANN MULLIS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health |
Additional Taxonomies | 106S00000X Behavior Technician |
Enumeration Date | 2018-09-12 |
Last Update Date | 2024-02-28 |