| NPI | 1861859498 |
|---|---|
| Former Name | STEPHANIE LEIGH PERSUTTE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2016-01-27 |
| Last Update Date | 2016-09-29 |