| NPI | 1124170840 |
|---|---|
| Former Name | ROCHELLE MARIE KREDOVSKI |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 22104) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 301771) |
| Enumeration Date | 2007-01-16 |
| Last Update Date | 2017-06-30 |