| NPI | 1194827030 |
|---|---|
| Former Name | MARILYN JOY FISKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: MN 6615) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN 397) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2014-04-01 |