| NPI | 1427470103 |
|---|---|
| Former Name | TARA JEAN REINICKE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SD LPC-MH20376) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: SD LPC20223) |
| Enumeration Date | 2014-01-14 |
| Last Update Date | 2021-08-13 |