| NPI | 1366175192 |
|---|---|
| Former Name | JENNIFER STUDSTRUP |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA MC61294065) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CO61345268) |
| Enumeration Date | 2022-07-08 |
| Last Update Date | 2022-08-09 |