NPI | 1932836210 |
---|---|
Former Name | AMANDA FRANCES GIBSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.0020142) |
Additional Taxonomies | 101Y00000X Counselor (Licence: CO LPCC.0017802) |
Enumeration Date | 2022-08-05 |
Last Update Date | 2023-12-21 |