| NPI | 1578978615 |
|---|---|
| Former Name | LAUREN ELIZABETH BREEDLOVE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 10966) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 10966) |
| Enumeration Date | 2014-06-27 |
| Last Update Date | 2020-08-28 |