NPI | 1982134441 |
---|---|
Former Name | GLENNA EDWARDS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AR P0611066) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2017-06-18 |
Last Update Date | 2021-06-22 |