| NPI | 1568732287 |
|---|---|
| Former Name | AMY LYNN DORN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 7730-125) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WI 7730-125) |
| 101Y00000X Counselor | |
| Enumeration Date | 2012-01-11 |
| Last Update Date | 2022-01-03 |