| NPI | 1174235386 |
|---|---|
| Former Name | AUDRIANA J HOLSTEIN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CT 7531) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WA MC61406242) |
| Enumeration Date | 2022-12-19 |
| Last Update Date | 2024-12-03 |