| NPI | 1316713241 |
|---|---|
| Former Name | REBECCA LOU RONNING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 305375) |
| Enumeration Date | 2023-12-01 |
| Last Update Date | 2023-12-01 |