NPI | 1992322747 |
---|---|
Former Name | AMBER BRANDT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO LPC.0018590) |
Additional Taxonomies | 103TC1900X Psychologist, Counseling (Licence: CO LPCC.0017567) |
Enumeration Date | 2020-06-28 |
Last Update Date | 2022-08-30 |