NPI | 1952910671 |
---|---|
Former Name | MARLENA HOLMES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor (Licence: MO 2018011004) |
Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MO 2018011004) |
Enumeration Date | 2020-07-28 |
Last Update Date | 2022-12-19 |