| NPI | 1679818074 |
|---|---|
| Former Name | LAURA J MACKENZIE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: GA 008111) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: MI 6401012348) |
| Enumeration Date | 2012-12-11 |
| Last Update Date | 2016-12-12 |