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Individual
ISSA PARK
Active
Individual
ISSA PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
87758
TX
101YP2500X
Professional Counselor
Primary
LH60687373
WA
Other
Enumeration date
10/25/2016
Last updated
01/19/2023
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