| NPI | 1023564093 |
|---|---|
| Former Name | JUSTINE MALKE WELCH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MN 2927) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 303216) |
| Enumeration Date | 2016-08-30 |
| Last Update Date | 2018-07-09 |