| NPI | 1831115716 |
|---|---|
| Former Name | AUDREY MARIE DIEFFENBAUGHER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WV 2569) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: OH E0004177) |
| 101YP2500X Counselor, Professional (Licence: OH E0004177) | |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2024-04-15 |