| NPI | 1427559970 |
|---|---|
| Former Name | LAURYN MIZUHARA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: PA PC007778) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2018-02-21 |
| Last Update Date | 2023-12-12 |