| 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 |