NPI | 1225338924 |
---|---|
Former Name | CORIE GAYLE RODEMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IL 166.001282) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IL 208.000574) |
Enumeration Date | 2010-10-27 |
Last Update Date | 2023-08-03 |