| NPI | 1972093425 |
|---|---|
| Former Name | REBECCA LANE HENRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: AL 04222) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: LA 7496) |
| Enumeration Date | 2018-05-10 |
| Last Update Date | 2025-10-01 |