NPI | 1619382520 |
---|---|
Former Name | SARAH VANDERWERF |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180.009178) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180009178) |
Enumeration Date | 2014-06-30 |
Last Update Date | 2019-04-22 |