| 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 |