NPI | 1548308919 |
---|---|
Former Name | MIRACLE RAYE HAASE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ND 537-9-15-05-254) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MN 01726) |
Enumeration Date | 2007-02-01 |
Last Update Date | 2024-11-22 |