| NPI | 1578080743 |
|---|---|
| Former Name | LISA ZYLSTRA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP6538) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2017-08-28 |
| Last Update Date | 2020-07-21 |