NPI | 1487103966 |
---|---|
Former Name | LAUREN DEVLIN REISER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA 86722) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA 86722) |
Enumeration Date | 2016-09-26 |
Last Update Date | 2019-01-08 |