| NPI | 1144839788 |
|---|---|
| Former Name | RACHAEL ANN MIEDEMA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SD LPC-MH30593) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IA 112727) |
| 101YP2500X Counselor, Professional (Licence: MN cc03615) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SD 16091731) | |
| 101YM0800X Counselor, Mental Health (Licence: SD LPC7420) | |
| Enumeration Date | 2020-07-29 |
| Last Update Date | 2024-01-16 |