NPI | 1942823901 |
---|---|
Former Name | SUZETT DELICIA BLOUNT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC011523) |
Additional Taxonomies | 101Y00000X Counselor (Licence: GA LPC011523) |
101YM0800X Counselor, Mental Health (Licence: GA LPC011523) | |
Enumeration Date | 2020-05-26 |
Last Update Date | 2024-08-02 |