NPI | 1447692645 |
---|---|
Former Name | JENNIFER MARIE DECKER VAN SWEDEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MN 2571) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: HI 349) |
Enumeration Date | 2013-07-29 |
Last Update Date | 2024-08-16 |