NPI | 1124647615 |
---|---|
Former Name | PETER ALLEN SANNEMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MD LC12394) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: VA 0701011435) |
101YP2500X Counselor, Professional (Licence: DC PRC200001455) | |
Enumeration Date | 2020-04-14 |
Last Update Date | 2024-05-14 |