NPI | 1659346690 |
---|---|
Former Name | VICKI JAYME LUNDIN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | |
Primary Taxonomy | 101YP2500X Counselor Professional (Licence: AZ LAC11705) |
Additional Taxonomies | 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: AZ RN030323) |
Enumeration Date | 2006-02-22 |
Last Update Date | 2007-07-08 |