NPI | 1720110232 |
---|---|
Former Name | MARI ELIZABETH JENSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR OR 97-04-75) |
Enumeration Date | 2007-03-10 |
Last Update Date | 2007-07-13 |