NPI | 1073925350 |
---|---|
Former Name | PANDORA KAY ZIOKOWSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MT SWP-LCPC-LIC-7854) |
Additional Taxonomies | 225C00000X Rehabilitation Counselor (Licence: MT 00111462) |
Enumeration Date | 2014-05-21 |
Last Update Date | 2014-09-10 |