NPI | 1972721991 |
---|---|
Former Name | HEATHER LIGHTLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC3378) |
Additional Taxonomies | 101Y00000X Counselor (Licence: MD LGP340) |
Enumeration Date | 2007-04-23 |
Last Update Date | 2010-01-25 |