NPI | 1720648975 |
---|---|
Former Name | NICOLE MARIE DICKMAN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OH E.2202994) |
Additional Taxonomies | 101Y00000X Counselor (Licence: OH C.1801491) |
Enumeration Date | 2019-06-19 |
Last Update Date | 2023-02-27 |