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 |