| NPI | 1124588900 |
|---|---|
| Former Name | ALICIA MANGRUM-NUSS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IL 180003308) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180003308) |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2025-08-12 |