| NPI | 1528548880 |
|---|---|
| Former Name | MARJORIE LUANNE NICHOLS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: C.2002461) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| Enumeration Date | 2018-08-16 |
| Last Update Date | 2021-07-01 |