NPI | 1073557229 |
---|---|
Former Name | JAMIE R REDDERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180033993) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI 3206-125) |
101YP2500X Counselor, Professional (Licence: WI 3206-125) | |
Enumeration Date | 2006-06-16 |
Last Update Date | 2023-11-22 |