| NPI | 1194181610 |
|---|---|
| Former Name | SAMANTHA EDQUIST |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 6844-125) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 2861-226) |
| Enumeration Date | 2016-01-13 |
| Last Update Date | 2021-11-22 |