NPI | 1205338969 |
---|---|
Former Name | TARA M SCHLOE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MN 17338) |
Additional Taxonomies | 101YS0200X Counselor School (Licence: MN 429597) |
Enumeration Date | 2018-03-08 |
Last Update Date | 2018-03-08 |