| NPI | 1285201194 |
|---|---|
| Former Name | LAURA JANE KOENIG |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NE 12498) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NE 7581) |
| Enumeration Date | 2021-06-09 |
| Last Update Date | 2021-06-09 |