NPI | 1740397579 |
---|---|
Former Name | VIRGINIA MARIE CEDERHOLM (MAIDEN NAME) |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WA LH00010830) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health |
Enumeration Date | 2006-08-25 |
Last Update Date | 2010-09-20 |