| NPI | 1164642922 |
|---|---|
| Former Name | MARY ELIZABETH RUBLE TWARDOKUS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH14480) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MI 6401010213) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2022-04-25 |