| NPI | 1841442209 |
|---|---|
| Former Name | DENA MARIE WANNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical (Licence: MN LP5133) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: ND LP575P) |
| Enumeration Date | 2008-10-16 |
| Last Update Date | 2020-01-31 |