| NPI | 1215317631 |
|---|---|
| Former Name | STEPHANIE RENESON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: MN 822) |
| Additional Taxonomies | 103TC0700X Psychologist Clinical (Licence: MN 822) |
| Enumeration Date | 2015-06-01 |
| Last Update Date | 2023-12-12 |