NPI | 1598055535 |
---|---|
Former Name | HANNAH WAGNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MI 6401012251) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MI L1864782) |
Enumeration Date | 2011-04-11 |
Last Update Date | 2024-01-11 |