NPI | 1942677885 |
---|---|
Former Name | BRENDA ROZIER CLARK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701002536) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: VA 0717000802) |
Enumeration Date | 2015-08-26 |
Last Update Date | 2015-08-26 |