| NPI | 1952883845 |
|---|---|
| Former Name | MELODIE JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA 60897298) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA 60889593) |
| Enumeration Date | 2018-09-06 |
| Last Update Date | 2024-01-23 |