| NPI | 1336733286 |
|---|---|
| Former Name | CARLY N KRUEGER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 10226-125) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 19153) |
| 101YP2500X Counselor, Professional (Licence: WI 4662) | |
| Enumeration Date | 2021-02-22 |
| Last Update Date | 2023-03-31 |