NPI | 1972759991 |
---|---|
Former Name | BRANDY KUEREINE O'ROURKE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103K00000X Behavior Analyst (Licence: MD LBA001) |
Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: VA 1-07-3491) |
Enumeration Date | 2008-08-11 |
Last Update Date | 2024-06-02 |