| NPI | 1669744090 |
|---|---|
| Former Name | LEAH JACOBSEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6451021951) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2012-02-01 |
| Last Update Date | 2022-10-06 |