NPI | 1366737520 |
---|---|
Former Name | LISA L OLSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN 00486) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: ND 687-6-1-11) |
Enumeration Date | 2011-06-16 |
Last Update Date | 2018-04-18 |