| NPI | 1790338101 |
|---|---|
| Former Name | CARLENE ROSE REICHMUTH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 2886) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2019-07-24 |
| Last Update Date | 2021-11-17 |