| NPI | 1770311102 |
|---|---|
| Former Name | AMANDA LEE ELFTMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 11209) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI 11209) |
| Enumeration Date | 2024-07-25 |
| Last Update Date | 2024-08-27 |