NPI | 1093756041 |
---|---|
Other Name | STEPHANIE ANN UNTIEDT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103TC1900X Psychologist, Counseling (Licence: MN 4599) |
Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: MN 4599) |
Enumeration Date | 2006-06-09 |
Last Update Date | 2015-02-01 |