NPI | 1710198593 |
---|---|
Former Name | GRETA MARIE LUTMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 2936) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 607) |
101YP2500X Counselor, Professional (Licence: GA 6849) | |
Enumeration Date | 2007-05-24 |
Last Update Date | 2019-08-06 |