NPI | 1750883872 |
---|---|
Former Name | LAUREN JUSTINE YOUNG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401017648) |
Additional Taxonomies | 101Y00000X Counselor (Licence: OH C.1700511) |
Enumeration Date | 2018-03-05 |
Last Update Date | 2022-11-23 |