| NPI | 1568755254 |
|---|---|
| Former Name | ANNELIESE ELLEFSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WI 9338-120) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 15781) |
| Enumeration Date | 2011-05-27 |
| Last Update Date | 2014-11-18 |