| NPI | 1265800809 |
|---|---|
| Former Name | ELENA MARIE ECKELBERG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: FL MH16647) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 19692) |
| Enumeration Date | 2015-09-14 |
| Last Update Date | 2025-09-23 |