NPI | 1396294302 |
---|---|
Former Name | JORDAN MOLLER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 2623) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NE 5248) |
Enumeration Date | 2016-10-03 |
Last Update Date | 2021-08-24 |