| NPI | 1063714913 |
|---|---|
| Former Name | AMANDA LOUISE BOBLITZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC5023) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LC5023) |
| Enumeration Date | 2010-11-29 |
| Last Update Date | 2016-11-08 |