| NPI | 1740671197 |
|---|---|
| Former Name | DEANNA MARIE MEDER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MT SWP-LCPC-LIC-11614) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO LPC.0012063) |
| Enumeration Date | 2015-02-06 |
| Last Update Date | 2019-03-26 |