| NPI | 1497321954 |
|---|---|
| Former Name | CARESSA AMUNDSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2021-06-03 |
| Last Update Date | 2022-06-02 |