| NPI | 1578900411 |
|---|---|
| Former Name | AMANDA KATHERINE GLOUDEMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MN cc01110) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2013-06-02 |
| Last Update Date | 2022-04-13 |