NPI | 1720508500 |
---|---|
Former Name | JORDAN GILBERTSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MN cc02043) |
Additional Taxonomies | 174400000X Specialist |
Enumeration Date | 2017-06-22 |
Last Update Date | 2019-10-14 |