| NPI | 1396095006 |
|---|---|
| Former Name | JORDAN ELIZABETH WILDMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO LPC.0013032) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2012-09-11 |
| Last Update Date | 2022-08-19 |