| NPI | 1194709287 |
|---|---|
| Former Name | LORI DIANE CRUM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: IN 34003425A) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: IN 34003425A) |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2014-09-03 |