NPI | 1801199302 |
---|---|
Former Name | JENNIFER MARIE KETZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: MN 2425) |
Additional Taxonomies | 106H00000X Marriage & Family Therapist |
Enumeration Date | 2010-12-06 |
Last Update Date | 2015-10-22 |