| NPI | 1972003911 |
|---|---|
| Former Name | AMY EVERSOLE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CO LPC.0015056) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2018-02-16 |
| Last Update Date | 2023-10-26 |