NPI | 1992062723 |
---|---|
Former Name | SARAH JOHNSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC006279) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: PA PC006279) |
Enumeration Date | 2012-04-18 |
Last Update Date | 2020-07-15 |