NPI | 1831565829 |
---|---|
Former Name | MALLORY ANDREASSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: IA 092680) |
Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MN cc01021) |
Enumeration Date | 2015-08-13 |
Last Update Date | 2024-10-19 |