NPI | 1972095057 |
---|---|
Former Name | SAMANTHA MARSHALL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO LPC.0016667) |
Additional Taxonomies | 101Y00000X Counselor |
101YP2500X Counselor, Professional (Licence: CO LPC.0016667) | |
Enumeration Date | 2018-06-04 |
Last Update Date | 2024-09-07 |