| NPI | 1689129405 |
|---|---|
| Former Name | AMANDA HUSNICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IL 166.001233) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: IL 208.000479) |
| Enumeration Date | 2016-08-22 |
| Last Update Date | 2020-07-06 |