NPI | 1295068096 |
---|---|
Former Name | DEBRA D KUEKER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180003856) |
Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: IL 041226266) |
Enumeration Date | 2009-09-10 |
Last Update Date | 2009-09-10 |