| NPI | 1689814279 |
|---|---|
| Former Name | LAURA S PEDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 4171) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MN cc00127) |
| 101YP2500X Counselor, Professional (Licence: WI 4171-125) | |
| Enumeration Date | 2009-02-23 |
| Last Update Date | 2025-07-16 |