NPI | 1689150633 |
---|---|
Former Name | ANDREA KORDIK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 2586) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: NE 201) |
Enumeration Date | 2018-07-12 |
Last Update Date | 2024-01-19 |