NPI | 1992914162 |
---|---|
Former Name | DANA BOLDT GREEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OK 2011) |
Additional Taxonomies | 103K00000X Behavior Analyst (Licence: OK LPC2011) |
Enumeration Date | 2007-05-22 |
Last Update Date | 2014-04-11 |