| 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 | 2022-10-28 |