| NPI | 1598132623 |
|---|---|
| Former Name | LORI L WILDBERGER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO 0012472) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MO 002266) |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2016-10-03 |