| NPI | 1982959276 |
|---|---|
| Former Name | MANDY LYNN MILSTEAD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH10654) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YP2500X Counselor Professional | |
| Enumeration Date | 2012-07-23 |
| Last Update Date | 2012-07-23 |