| NPI | 1659322915 |
|---|---|
| Former Name | JULIANNE MARIE RECKNOR |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP4855) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: IA 01001) |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2018-12-14 |