| NPI | 1497220941 |
|---|---|
| Former Name | STACI RENAE BIELENBERG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: OR 41084) |
| Additional Taxonomies | 101Y00000X Counselor |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2018-10-11 |
| Last Update Date | 2024-12-20 |