| NPI | 1700283322 |
|---|---|
| Former Name | HEATHER MICHELLE JOHANNINGMEIER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: IA 075287) |
| Enumeration Date | 2014-11-25 |
| Last Update Date | 2014-11-25 |