NPI | 1609362920 |
---|---|
Former Name | JENIFER WILLENZIK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC0012309) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2018-07-10 |
Last Update Date | 2024-02-12 |