NPI | 1801468236 |
---|---|
Former Name | AVERY SUNNARBORG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KS 03576) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MO 2021025689) |
Enumeration Date | 2021-07-14 |
Last Update Date | 2023-11-10 |