| NPI | 1992053078 |
|---|---|
| Former Name | LISA NELDON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ LPC-15811) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2012-08-21 |
| Last Update Date | 2016-02-03 |