| NPI | 1710304662 |
|---|---|
| Former Name | JORDAN NICHOLE RUDELIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: MO 2022035130) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 221700000X Art Therapist | |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2024-07-02 |