| 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 |