| NPI | 1689901126 |
|---|---|
| Former Name | VICKIE KATHLEEN HANEBERG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C4008) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OR C4008) |
| Enumeration Date | 2009-11-04 |
| Last Update Date | 2024-09-05 |