NPI | 1528575065 |
---|---|
Former Name | KAREN ANN HEINEMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 103T00000X Psychologist (Licence: MI 6361005105) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
Enumeration Date | 2018-01-05 |
Last Update Date | 2022-08-05 |