| NPI | 1477952638 |
|---|---|
| Former Name | STEPHANIE FEICKERT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: IA 007103) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: IA 10038) |
| Enumeration Date | 2014-08-13 |
| Last Update Date | 2014-08-13 |