NPI | 1366079014 |
---|---|
Former Name | AMANDA STEBOR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN 02044) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 305542) |
Enumeration Date | 2020-03-24 |
Last Update Date | 2023-09-12 |