| NPI | 1760962864 |
|---|---|
| Former Name | LYNN MARIE LUNDQUIST |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CA 110061) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CA 79804) |
| Enumeration Date | 2018-08-17 |
| Last Update Date | 2018-11-06 |