NPI | 1619421302 |
---|---|
Former Name | JULIANNE LINDSKOG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CA 11525) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 37439) |
101YP2500X Counselor, Professional (Licence: IL 180.013142) | |
Enumeration Date | 2016-08-10 |
Last Update Date | 2023-08-31 |