| NPI | 1063296747 |
|---|---|
| Former Name | JORDAN L KOONTZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MO 2023042180) |
| Enumeration Date | 2023-08-23 |
| Last Update Date | 2025-01-14 |