NPI | 1164763363 |
---|---|
Former Name | DAWN MARIE KRULL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6361007574) |
Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
Enumeration Date | 2013-03-13 |
Last Update Date | 2024-02-08 |