| NPI | 1639780943 |
|---|---|
| Former Name | JACQUELINE FIEGE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YM0800X Counselor, Mental Health (Licence: WI 8515-125) | |
| Enumeration Date | 2020-08-11 |
| Last Update Date | 2023-03-30 |