NPI | 1558860155 |
---|---|
Former Name | CHRISTINA MARIE KOEPPEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA LPCC6029) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AZ LPC18978) |
Enumeration Date | 2018-02-08 |
Last Update Date | 2022-05-03 |