NPI | 1972975431 |
---|---|
Former Name | TAMI LYNNE GRAVILLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA 61091134) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
103K00000X Behavior Analyst | |
Enumeration Date | 2015-10-23 |
Last Update Date | 2023-12-14 |