| NPI | 1336502194 |
|---|---|
| Former Name | ALYSSA FENNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: OH E.2001788) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH C1400294) |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2020-07-02 |