| NPI | 1659857225 |
|---|---|
| Former Name | LAUREL LUKKEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: LA 6319) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: GA LPC011740) |
| Enumeration Date | 2018-07-16 |
| Last Update Date | 2024-01-25 |