NPI | 1174912570 |
---|---|
Former Name | JENNY KLUCARICH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OH E.1901516) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI 6328-125) |
Enumeration Date | 2015-01-22 |
Last Update Date | 2020-02-19 |