NPI | 1942415781 |
---|---|
Former Name | LASHAUN CLARK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IN 39001626A) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR C7395) |
Enumeration Date | 2007-05-14 |
Last Update Date | 2023-07-31 |