NPI | 1972994051 |
---|---|
Former Name | MEGAN KOONTZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA MC60536402) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: WA CO60528607) |
101Y00000X Counselor (Licence: WA MC60536402) | |
Enumeration Date | 2015-02-11 |
Last Update Date | 2016-03-04 |