| NPI | 1689970253 |
|---|---|
| Former Name | JENNA FAHLANDER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Enumeration Date | 2011-01-31 |
| Last Update Date | 2019-05-14 |