| NPI | 1760785224 |
|---|---|
| Former Name | JACQUELINE K REBSTOCK-SERBUS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MN 29075) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 302974) |
| Enumeration Date | 2010-12-06 |
| Last Update Date | 2023-01-11 |