| NPI | 1023231198 |
|---|---|
| Former Name | JEANNA LE SUER-MANDERNACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2016-07-28 |