NPI | 1194986588 |
---|---|
Former Name | LISA JO WEBER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: WI 660124) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: MN 1054) |
Enumeration Date | 2008-06-19 |
Last Update Date | 2009-06-02 |