NPI | 1134514987 |
---|---|
Former Name | MADELINE JEAN PROEHL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 11579) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC A11579) |
Enumeration Date | 2015-03-30 |
Last Update Date | 2023-12-18 |