| NPI | 1619323979 |
|---|---|
| Former Name | AMY MARIE BROEHM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 15284) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MN 1041C0700X) |
| Enumeration Date | 2016-05-05 |
| Last Update Date | 2020-08-27 |