| NPI | 1831574672 |
|---|---|
| Former Name | LAURI ANN WEICKERT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MN CC00583) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MN 303789) |
| Enumeration Date | 2015-07-22 |
| Last Update Date | 2022-12-23 |