| NPI | 1710444336 |
|---|---|
| Former Name | LAURA JEAN SPENCER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: IL 180.008140) |
| Additional Taxonomies | 225600000X Dance Therapist |
| Enumeration Date | 2019-03-01 |
| Last Update Date | 2019-03-01 |