| NPI | 1578112371 |
|---|---|
| Former Name | AMANDA JEAN KOLTZ-SLABAUGH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180.014389) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 178.015150) |
| 101YM0800X Counselor, Mental Health (Licence: IL 180.014389) | |
| Enumeration Date | 2019-09-05 |
| Last Update Date | 2022-07-11 |