| NPI | 1144626524 |
|---|---|
| Former Name | LAUREN WIEST |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: TN 3984) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: SC 5756) |
| Enumeration Date | 2014-11-12 |
| Last Update Date | 2018-05-16 |