NPI | 1649445040 |
---|---|
Former Name | AMY LYNN IMHOFF |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180.006756) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: IL 180006756) |
Enumeration Date | 2008-04-25 |
Last Update Date | 2022-05-11 |